Strategic Payer Contracting & Relations Manager

Golden Valley Health Centers; Atwater (CA); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Golden Valley Health Centers seeks a Payer Contracting and Relations Manager in Atwater to lead contract negotiations with Medicare, Medi-Cal and managed care plans, ensure compliance with state and federal regulations, and build strong payer relationships.

Based in Atwater with hybrid work options after acclimation, you will manage the end-to-end contract lifecycle, monitor performance metrics, resolve disputes, and drive payer strategies aligned with organizational goals.

Qualifications

• Experience negotiating contracts and managing payer relationships
• Knowledge of reimbursement methodologies and healthcare regulations
• Understanding of government programs such as Medicare and Medi-Cal
• Experience with population health initiatives and analytics
• Proficiency in Excel and other Microsoft tools; strong communication

Responsibilities

• Lead end-to-end contract negotiations with all payers, including Medicare, Medi-Cal and Managed Care plans
• Ensure all contracts comply with state, federal and healthcare regulations
• Manage the "signature to implementation" process, ensuring all contracts are properly executed and updated in the billing system
• Identify opportunities for network expansion and evaluate feasibility of new payment models
• Stay abreast of industry trends, regulatory updates and competitor pricing
• Maintain comprehensive payer contracts, terms, and renewal timelines
• Collaborate with executive leadership to develop payer strategies aligned with organizational goals
• Track payer trends and communicate impacts across the organization
• Prepare reports and present contract performance metrics to leadership
• Manage payer credentialing and enrollment processes
• Analyze contract terms and reimbursement to optimize revenue and reduce risk
• Work with health plans to resolve systemic issues and credentialing bottlenecks
• Collaborate with internal teams to ensure contract alignment and operational efficiency
• Participate in audits, appeals, and escalations related to payer issues

Skills

Contract negotiation

Payer relations

Healthcare analytics

Regulatory compliance

Excel

Communication

Multi-contract management

Education

Bachelor's degree in Healthcare Administration/Finance/Business Administration or related field

Five years of relative experience in lieu of degree

Tools

MS Office

Job description

Golden Valley Health Centers seeks a Payer Contracting and Relations Manager in Atwater to lead contract negotiations with Medicare, Medi-Cal and managed care plans, ensure compliance with state and federal regulations, and build strong payer relationships.

Based in Atwater with hybrid work options after acclimation, you will manage the end-to-end contract lifecycle, monitor performance metrics, resolve disputes, and drive payer strategies aligned with organizational goals.