Remote Senior Payor Contracting Leader

Healthcare Outcomes Performance Co. (HOPCo); Phoenix (AZ); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Healthcare Outcomes Performance Co. (HOPCo) in the United States is seeking an experienced professional to manage payor contracting and lead rate negotiations on behalf of providers.

The role focuses on developing baseline reimbursement analyses and coordinating with Revenue Cycle Management to maximize payment integrity. The ideal candidate has a strong background in managed care contracting, strategic analysis, and cross-functional collaboration with executive leadership.

Qualifications

• Proven working knowledge of provider financial issues, complex contracting options, financial/contracting arrangements and regulatory requirements.
• 7-10 years related experience and comprehensive level of analytic and negotiating skills with successful track record supporting contract negotiations with payors.
• Strong communication, critical thinking, problem resolution and interpersonal skills.
• Solid understanding of industry dynamics required.

Responsibilities

• Develop and maintain positive, effective relationships with internal and external customers and serve as the contracting liaison between contracted Payors and providers.
• Lead contract analysis and negotiations with Payors on behalf of providers including rates, payment methodologies, contract language and value- based payment programs in accordance with internal control processes for contract review, approval and signature.
• Lead development of Payor reimbursement analyses that can be routinely updated and maintained as a baseline for strategies to maximize health plan reimbursement and ensure payment integrity.
• Research and make recommendations to executive leadership in regard to payor contracting opportunities in new and existing geographic service area.
• Ensure compliance in all business and contractual relationships
• Identify and communicate trends and/or potential issues to market leadership and HOPCo management team.
• Lead development of infrastructure and analysis for strategic projects including rate transparency, payment validation and coordination with Revenue Cycle Management, payor contracting strategy including value based care glidepath.
• Other duties and responsibilities as assigned.

Skills

Verbal communication

Written communication

Attention to detail

Organization

Computer skills

Payor reimbursement

Managed care contracting

Market knowledge

Education

Bachelor’s Degree

Job description

Healthcare Outcomes Performance Co. (HOPCo) in the United States is seeking an experienced professional to manage payor contracting and lead rate negotiations on behalf of providers.

The role focuses on developing baseline reimbursement analyses and coordinating with Revenue Cycle Management to maximize payment integrity. The ideal candidate has a strong background in managed care contracting, strategic analysis, and cross-functional collaboration with executive leadership.