Manager, Payer Relations

2 weeks ago


Dallas, Texas, United States RPC Company Full time

The Manager of Payer Relations plays a critical role in maintaining credentialing & payor relationships. This position maintains strong relationships with payers and ensures effective communication between the company, clinicians, and stakeholders.

Required:

  • Candidate needs a bachelor degree in Finance, Healthcare Administration, or a similar/relatable field
  • Over 5 years of experience in payer/provider contracting and reimbursement
  • Proficient in credentialing and contracting
  • In-depth understanding of contract components such as CPTs, DRG, FFS, globals, etc.
  • Exceptional attention to detail, with strong organizational and project management abilities
  • Excellent time management and multitasking skills are needed
  • OSHA Certification

Here are the key responsibilities:

Payer Relationship Development & Contracts:

  • Cultivate and maintain positive relationships with payers.
  • Implement pricing strategies to optimize reimbursement.
  • Communicate payer participant requirements to company clinicians and stakeholders.

Payer Reimbursement Models:

  • Take the initiative in developing and evaluating new payer reimbursement models.
  • Collaborate with company leadership to manage performance under these arrangements.
  • Ensure payer behaviors align with respective contracts

Credentialing Management:

  • Oversee the credentialing function for both payor and facility enrollment for 140+ providers
  • Maintain timelines & communication of all reappointments & onboarding of new providers
  • Collaborate with Revenue Cycle leadership to ensure compliance with payer-specific billing requirements.


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