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Payer Relations Manager, USA

South San Francisco, CA, USA; Remote

Role

The Payer Relations Manager is responsible for managing business relationships with Payers. These responsibilities include developing, obtaining and managing new Payer contracts, negotiating reimbursement rates and payment related terms with both new and existing Payers, maintaining good working relationships with assigned Payers, and assuring that appropriate reimbursement levels are being realized.

Duties and Responsibilities

  • Drive and develop plans for negotiation and contracting with payers.
  • Determine Payer assignments and geographic service areas to target.
  • Engage health plans, radiology-benefit managers, and hospitals in scientific dialogue about our products and pipeline.
  • Initiate and maintain contracts effectively with a focus on improving reimbursement rates and terms that maximizes enterprise revenues with local, regional and national Payers.
  • Develop and maintain a productive and positive working relationship with key local, regional and national Payers through their local market managers and regional executives.
  • Coordinate with physician offices to successfully implement the overall communication of new agreements.
  • Coordinate with Legal to assure contracts are compliant with State and Federal regulations and requirements.
  • Successfully implement the overall communication plan and ongoing communication with Payers.

Skills and Requirements: Essential

  • Bachelor of Science in Healthcare, Healthcare Administration, Business or similar discipline.
  • Extensive experience working in a payer and or provider contracting/reimbursement environment.
  • Experience with Fee for Service, Risk and Value Based Contracts for Commercial, Medicare Advantage, Medicaid products.
  • Experience with healthcare financing and provider reimbursement methodologies.
  • Extensive knowledge of the payer contracting process and payer/provider contracts.
  • Strong negotiation skills and sound decision-making skills.
  • Solid strategic planning and implementation skills.
  • Excellent written and verbal communication skills.
  • Ability and willingness to travel as needed.
  • Demonstrated ability to excel and influence in a matrix environment.

Skills and Requirements: Desired

  • Experience in medical devices and or medical imaging.
  • • Existing networks with payers

Interested in this position?

We are always looking for brilliant people to join us here at Perspectum Diagnostics.

Use the form below to send us your application.