Payor Relations Strategist — Contracts & Revenue Strategy

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

Job summary

CHOP is seeking a Payor Relations Specialist to support the Reimbursement Strategy and Contracting Department in understanding payor contracts, ensuring contract compliance, improving revenue streams, and reducing administrative barriers across the health system.

You will coordinate with department and divisional leadership to address unresolved managed care issues, participate in analyzing new and renewal contracts with payors, and assist in contract negotiations as needed.

Qualifications

• Bachelor's Degree required.
• 7+ years industry experience in payor contracts or managed care.
• Strong analytical and communication abilities.

Responsibilities

• Supports the enterprise by being the source of information related to payor contracts and policies.
• Provides contract interpretation and education; identifies opportunities in payor agreements.
• Organizes and leads contract implementation, including new agreements and terminations.
• Serves as primary contact with payors for rate changes and collaborates with Revenue Analytics.

Skills

Managed care knowledge

Communication skills

Organizational skills

Interpersonal skills

Independent work

Written and oral communication

Data interpretation

Collaboration

Education

Bachelor's Degree - Required

Tools

EPIC

Microsoft Office

Job description

CHOP is seeking a Payor Relations Specialist to support the Reimbursement Strategy and Contracting Department in understanding payor contracts, ensuring contract compliance, improving revenue streams, and reducing administrative barriers across the health system.

You will coordinate with department and divisional leadership to address unresolved managed care issues, participate in analyzing new and renewal contracts with payors, and assist in contract negotiations as needed.