Manager, Payer Contracting

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🏄 California – Remote

🏄 California – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Salinas Valley Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1953

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare Insurance • Non-profit

Salinas Valley Health is a trusted healthcare provider founded in 1953, originally as the Salinas Valley Health Medical Center, serving the Monterey County community. Over the years, it has grown to offer a wide range of specialized and general medical services with a focus on improving the health and well-being of its patients of all ages. The organization is known for its quality services, including cancer care, neurology, women's health, orthopedics, cardiac care, and surgery. Salinas Valley Health is committed to delivering quality healthcare locally and maintaining a strong commitment to community engagement and support through various health initiatives and programs.

📋 Description

• Promote and manage all managed care contracting efforts on behalf of the hospital and clinics • Responsible for assisting with all payer contracting • Negotiate, implement, and maintain all payer contracts and the respective policies for each • Keep abreast of all managed care marketplace activities and adjust strategies accordingly • Accountable for the negotiation, implementation, and contract performance tracking of all managed care contracts for the health system • Review and analyze contract language, including reimbursement methodologies and fee schedules • Maintain the centralized contract repository and ensure version control • Ensure contracts comply with federal and state regulations and partner with internal and external Legal teams to review terms to mitigate risk • Serve as the primary liaison between the organization and payer representatives • Support operational teams with contract interpretation and issue resolution • Identify and negotiate supplemental payments • Track key contract metrics including payer mix, expiration/renewal dates, and reimbursement rates • Lead and maintain collaborative payer and employer relationships

🎯 Requirements

• Bachelor’s degree required • Three (3) years’ experience in managed care contracting • Experience working with Epic • Experience working with contract management software • Knowledge of California and Federal rules related to managed care contracting, billing and compliance • Knowledge of population health and total cost of care • Proficient in Microsoft Office applications, including Excel, PowerPoint and Word • Excellent skills in dealing with members of the public, patients and co-workers by utilizing positive communication, both written and verbal

🏖️ Benefits

• None