Payor Contracts & Revenue Strategy Lead

The Children's Hospital of Philadelphia; Philadelphia (Philadelphia County); On-site; USD 76,000 - 97,000; Full time

Job summary

The Payor Relations Specialist at The Children's Hospital of Philadelphia coordinates with the Reimbursement Strategy and Contracting Department to understand payor contracts, ensure compliance, and improve revenue cycles across the health system.

Key duties include contract interpretation, identifying operational opportunities, and leading contract implementations and renewals. Strong experience in managed care and excellent communication are required.

Qualifications

• Bachelor's degree required.
• At least seven years of related experience.
• Strong understanding of local managed care environment.
• Excellent communication and organizational skills.

Responsibilities

• Maintains knowledge of payor contracts, policies and guidelines across the health system.
• Provides contract interpretation and education to the health system; identifies opportunities for payor agreements.
• Analyzes new and renewal contracts with payors; prepares business perspectives for Legal review.
• Acts as primary contact with payors for rate changes and collaborates with Access and Revenue Cycle teams to remove barriers.

Skills

Communication

Organization

Multitasking

Interpersonal skills

Independent work

Team collaboration

Presentation

EPIC

Microsoft Office

Data summarization

Managed care knowledge

Education

Bachelor's Degree

Tools

EPIC

Microsoft Office

Job description

The Payor Relations Specialist at The Children's Hospital of Philadelphia coordinates with the Reimbursement Strategy and Contracting Department to understand payor contracts, ensure compliance, and improve revenue cycles across the health system.

Key duties include contract interpretation, identifying operational opportunities, and leading contract implementations and renewals. Strong experience in managed care and excellent communication are required.