Payor Relations, Contracting Manager

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $85k - $95k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Acorn Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2018

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

Consulting • Logistics • Healthcare Insurance

Acorn Health is a specialized healthcare provider focusing on delivering high-quality Applied Behavior Analysis (ABA) therapy for children with autism. They work with young children, starting as early as 18 months, to help them develop crucial communication and social skills necessary for independent and meaningful lives. Acorn Health combines best practices with innovative approaches, ensuring personalized therapy plans that address each child's unique needs. With a commitment to evidence-based treatments, Acorn Health tracks progress using the Behavioral Health Index, and accepts most major insurance plans for treatment.

📋 Description

• Manage relationships with assigned commercial and Medicaid payors and serve as a key point of contact • Support referral growth, patient access, and collaboration with payor case managers and representatives • Lead and participate in regular payor meetings, presenting census, referral, staffing, access, and performance metrics • Analyze payor data and reports to identify trends, growth opportunities, and barriers to patient access • Manage payor contracting activities, including new agreements, renewals, amendments, reimbursement negotiations, and network participation • Partner with Revenue Cycle, Finance, Operations, and Credentialing to review contract terms and assess financial and operational impact • Coordinate internal review and approval of proposed contract terms and identify issues requiring escalation • Track contract renewals, deadlines, reimbursement changes, and implementation requirements • Support payor onboarding, credentialing, enrollment, and network participation activities • Help resolve complex payor, referral, authorization, operational, and reimbursement issues • Maintain accurate payor profiles, contacts, contract information, and relationship plans • Stay informed about payor requirements and applicable healthcare regulations • Identify opportunities to improve payor partnerships, operational processes, and access to care • Travel up to 15% as needed

🎯 Requirements

• 5+ years of experience in payor relations, healthcare reimbursement, contracting, or a related healthcare field (commercial and/or Medicaid MCOs) • Experience with authorizations, referrals, or payor-facing workflows • Experience in ABA or behavioral health is highly preferred • Strong communication and relationship-building skills • Strong organization and follow-through, with the ability to manage multiple priorities • Experience working cross-functionally with Finance, Revenue Cycle, Operations, Credentialing, and Legal • Comfort working in a fast-paced, collaborative healthcare environment • Proficiency with Microsoft Office (Word, Excel, PowerPoint) • Willingness to travel up to 15% • Bachelor’s degree in a related field preferred

🏖️ Benefits

• Generous Paid Time Off (PTO) and paid holidays • Medical, dental, and vision insurance • Paid Parental Leave • 401(k) Retirement Plan • Life insurance, short-term, and long-term disability coverage • Mission-driven work that truly makes a difference in the lives of children and families