Payor Relations Manager/Senior Analyst

1 Month ago • 3-5 Years

Job Summary

Job Description

The Payor Relations Manager/Senior Analyst will lead negotiations with insurance companies to secure favorable payer contracts, build analytical platforms to justify rate increases, develop business cases, and oversee analytics strategies for actionable insights. This role involves relationship management with payer stakeholders, negotiation of rate increases, and reimbursement research for billing. The analyst will also analyze payer behavior trends and provide analysis to the Business Development/Sales Team.

Must have:

Bachelor's degree in healthcare administration or related field
3-5 years of experience in payer contracting
Experience in building and implementing analytical platforms
Experience in crafting persuasive business cases
In-depth knowledge of healthcare analytics

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Job Details

Payor Relations Manager/Senior Analyst (Healthcare)

Are you a seasoned professional in the healthcare industry with a passion for strategic negotiation and analytics? Join our dynamic team as a Payor Relations Manager/Senior Analyst, where you will play a crucial role in shaping and optimizing our payer relationships.

Key Responsibilities:

Payer Contracting Negotiation: Lead negotiations with insurance companies to secure favorable payer contracts, ensuring optimal terms for both parties.
Analyzes the potential impact of contract re‐negotiations by building proposed rates into the Contract Management System and modeling the financial impact.
Analytical Platforms: Spearhead the development of analysis to build a compelling business case to justify rate increases with Payers.
Business Case Development: Utilize your experience in building robust business cases to support and guide key organizational decisions.
Analytics: Oversee the development and implementation of analytics strategies to derive actionable insights from complex healthcare data.
Relationship Management: Build and maintain relationships with key payer stakeholders and organizations
Negotiation with Insurance Companies: Leverage your relationships and negotiation skills to negotiate rate increases with insurance companies, ensuring mutually beneficial agreements for all stakeholders.
Reimbursement research
Collect, organize and interpret reimbursement data for CMS1500 and UB for billing.
Research and coordinates with compliance for Revenue Cycle requirements for facility and non-facility operations.
Provide feedback to Revenue Cycle for opportunities at financial improvement.
Analyze payor behavior trends across the nation on a facility/non facility and state‐wide scale.
Examine outside data from prospective clients and provide analysis to the Business Development/ Sales Team.

Qualifications:

Bachelor's degree in healthcare administration, Business, or a related field; master's degree preferred.
Minimum of 3-5 years of experience in payer contracting, with a focus on negotiation and analytics.
Proven track record in building and implementing analytical platforms.
Strong experience in crafting persuasive business cases.
In-depth knowledge of healthcare analytics and negotiating with insurance companies.

Location: Chicago, IL
Full Time/Part Time
Work Set up - Remote/Onsite

If you are a strategic thinker with a passion for negotiating and a strong background in analytics, we invite you to bring your expertise to our team. Apply now by submitting your resume to ronel@neolytix.com with the subject line "Payor Relations Manager/Senior Analyst"