Manager, Payor Relations

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🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 10%

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Adaptive Home Health

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2020

🏥 Healthcare

👥 B2C

🤝 B2B

Healthcare • B2C • B2B

Adaptive Home Health is an employee-owned, Texas-based home health provider delivering skilled nursing, specialty wound and infusion care, physical and occupational therapy, and orthopedic rehabilitation to patients in their homes. Led by a team of veterans and nurses, the company partners with hospitals, physician groups, wound centers and research institutions across North Texas, Austin, Houston and other Texas regions, is Medicare- and VA-accepted, and operates a 24/7 billing and patient advocacy hotline to support high-acuity and post-hospital recovery care. Adaptive emphasizes patient-focused, in-home clinical services with a large full-time clinical staff and regional offices across Texas.

📋 Description

• Own the organization's relationships with commercial and government health plans • Serve as the primary relationship owner and escalation contact for assigned health plans • Support contract negotiations and renewals by analyzing rates, terms, volume, and financial impact • Track renewal dates, notice deadlines, and rate changes • Partner with revenue cycle to resolve recurring denials, underpayments, payment delays, and authorization issues • Drive process changes that prevent recurring payment and authorization problems • Monitor payer performance, including contract compliance, denial rates, accounts receivable aging, and escalation trends • Report payer performance findings and recommendations to leadership • Evaluate network participation opportunities and payer changes affecting patient access or financial performance • Coordinate with credentialing and enrollment on participation issues • Coordinate with legal and compliance on contract language and disputes • Communicate material payer policy and contract changes to affected teams • Deliver strong renewal outcomes, timely escalation resolution, fewer recurring denials and underpayments, faster payments, and accurate payer performance reporting

🎯 Requirements

• Bachelor's degree in healthcare administration, business, finance, or a related field, or equivalent experience • 3+ years in payer relations, managed care contracting, revenue cycle, or reimbursement analysis, including direct work with health plans on contract, claims, or payment issues • Working knowledge of reimbursement methods, payer contracts, claims workflows, and the drivers of denials and underpayments • Ability to analyze financial and operational data and turn it into clear, practical recommendations • Strong negotiation, relationship management, and project management skills • Direct experience negotiating or implementing commercial and Medicare Advantage contracts • Familiarity with credentialing, enrollment, and value-based payment arrangements • Experience with contract management, claims analysis, or revenue cycle reporting tools • Legally authorized to work in the United States

🏖️ Benefits

• Competitive salary and equity compensation • Comprehensive health insurance, dental, and commuter benefits • 401(k) retirement plan with employer contribution • Flexible time off policy — we expect most employees to take at least 3 weeks of vacation per year • Opportunity for growth in a fast-growing company • Collaborative team valuing innovation and problem-solving