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.

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"