Strategic Payer Negotiations Lead (Remote)

CenterWell Home Health; Utah; Remote; USD 139,000 - 191,000; Full time

Job summary

CenterWell Home Health is seeking a Provider Contracting Principal to develop and execute payer strategy, lead negotiations, and manage payer relationships across national, regional, and local accounts.

You will partner with Sales, Operations, Finance, Revenue Cycle, Clinical and Compliance to translate enterprise priorities into market-level contracting, implementation, and performance improvements while ensuring financial viability and access.

Qualifications

• Bachelor’s degree in Business, Healthcare Administration, Finance, or a related field.
• Five or more years of experience in managed care, payer contracting, provider relations, payer account management, healthcare finance, business development or healthcare operations.
• Demonstrated experience interpreting payer agreements and leading contract negotiations.
• Strong financial acumen and demonstrated ability to evaluate reimbursement methodologies, contract economics, and business cases.
• Strong analytical, negotiation, problem-solving, stakeholder management and executive communication skills.
• Experience in home health, post-acute care and/or managed care.
• Knowledge of episodic, fee-for-service and value-based reimbursement payment models, authorization requirements and revenue cycle processes.
• Experience leading complex initiatives requiring coordination across multiple functional and operational stakeholders.
• Ability to manage multiple payer priorities, deadlines, negotiations and implementation activities with a high degree of independence.
• Experience with contract performance reporting, reimbursement analysis and payer-provider issue resolution.
• Experience presenting contracting strategies, business cases and recommendations to senior leadership.

Responsibilities

• Lead payer strategy and market opportunities.
• Negotiate reimbursement, operational, administrative, and other material contract provisions in collaboration with stakeholders.
• Coordinate stakeholder review, leadership approvals, agreement execution, renewal planning, and key contractual milestones.
• Lead cross-functional implementation of new and amended payer agreements, establishing owners, deliverables, milestones and escalation paths.
• Monitor contract performance, reimbursement, volume, and financial outcomes; identify optimization opportunities.
• Present contracting strategies, risks and business cases to leadership and governance forums.

Skills

Negotiation

Strategic planning

Financial analysis

Cross-functional

Executive communication

Education

Bachelor's degree in Business/Healthcare

Job description

CenterWell Home Health is seeking a Provider Contracting Principal to develop and execute payer strategy, lead negotiations, and manage payer relationships across national, regional, and local accounts.

You will partner with Sales, Operations, Finance, Revenue Cycle, Clinical and Compliance to translate enterprise priorities into market-level contracting, implementation, and performance improvements while ensuring financial viability and access.