Manager, Payer Contracting

🔥 14 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $75k - $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Brault

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1990

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance • Data Analytics

Brault is a company specializing in End-to-End Revenue Cycle Management (RCM) and practice management services tailored for healthcare providers, particularly in acute care settings. With over 25 years of experience, Brault offers customized solutions in areas such as coding and billing, provider education, practice analytics, and operational support to help physician groups and hospitals navigate the complexities of healthcare management. Led by Dr. Andrea Brault and a team of experts, the company is dedicated to enhancing the efficiency and effectiveness of healthcare practices nationwide.

📋 Description

• Support negotiation, implementation, and management of payer contracts to ensure optimal reimbursement and compliance • Establish or renew contracts under new Tax IDs as needed • Create and maintain contract summary forms for all clients • Monitor contract termination dates and coordinate renewals, renegotiations, or terminations • Process contract terminations and maintain payer contracts and related documents according to company file storage protocols • Gather and analyze data to support negotiation strategy, rate improvements, alternate payment models, and revenue cycle improvements • Assist with preparation and review of payer contracts, amendments, and fee schedules • Own and serve as subject matter expert for the payer contract module in Athena • Upload and maintain commercial and governmental fee schedules • Create and configure rule-based logic • Monitor variance reporting to identify rule updates, emerging payer trends, and inappropriate payer behavior such as underpayments • Monitor, interpret, and communicate payer policy updates, coverage determinations, and regulatory changes • Review payer behavior before contract expiration and recommend revised rates to maximize client reimbursement • Prepare reports and dashboards summarizing contract metrics and financial outcomes • Participate in client meetings as a subject matter expert on contract performance and improvement opportunities • Notify client managers about upcoming renegotiation or termination windows • Build relationships with payer Provider Representatives • Participate in team meetings addressing payment terms, underpayments, and contract-related trends • Partner with revenue cycle teams to resolve payment issues and assist with appeals or reconsiderations for underpaid or denied claims • Provide contract interpretation guidance to coding, billing, patient access, legal, compliance, operations, and clinical departments • Communicate contract updates and reimbursement changes to stakeholders • Support implementation of new payer programs, reimbursement models, and operational changes

🎯 Requirements

• Intermediate skills in Microsoft Outlook, Excel, PowerPoint, and Word • Proficient with Adobe • Effective written and verbal communication skills • Experience with Laserfiche preferred but not required • Knowledge of healthcare payer contracting, including commercial and government payers (Medicare, Medicaid, managed care) • Knowledge of payer contract terms, fee schedules, amendments, notices, and termination provisions • Knowledge of payer policies, coverage determinations, and regulatory requirements affecting reimbursement • Knowledge of data analysis and financial reporting related to contract performance and payer behavior • Experience with revenue cycle operations, including billing, coding, payment posting, underpayment analysis, clearinghouse, and appeals • Working knowledge of practice management or EHR systems, preferably Athena IDX and payer contract modules • Familiarity or experience with Payer Price or similar payer rate transparency tool • Proven track record of successful payer contracting negotiations • Ability to analyze, evaluate, and apply knowledge of market and healthcare trends to effectively convey the value of a contract • Bachelor's degree in a related field such as healthcare administration or business preferred • 3–5 years of experience in revenue cycle management, managed care, or a related healthcare financial role • 2+ years of experience in healthcare payer contracting • Ability to travel within the US and stay overnight as needed • Expected travel of 10–15% of the time

🏖️ Benefits

• Fully remote work arrangement • Travel opportunities to client visits, conferences, and industry-related events • Participation in key industry conferences and networking events

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