Payer Contracting Specialist

3 weeks ago


Oklahoma City, Oklahoma, United States Merraine Group Full time
Role Description

The Managed Care Negotiation Lead will play a pivotal role in negotiating and implementing commercial, government, and value-based payer contracts. You will drive financial outcomes, ensure compliance, and foster strong payer relationships while contributing to the organization's mission of delivering top-tier healthcare.

About the Role:

  • Negotiate and Execute Contracts: Manage agreements, amendments, Letters of Agreement (LOAs), and single-case agreements (SCAs) to meet financial goals and operational efficiency.
  • Oversee Value-Based Contracts: Negotiate and monitor performance, ensuring alignment with organizational objectives.
  • Financial Analysis: Prepare financial feasibility models and evaluate the impact of regulatory changes on contracts.
  • Support Operational Growth: Assist in creating business plans and budgets for new services.
  • Ensure Compliance: Monitor payer adherence to contractual and regulatory terms.
  • Customer Relationship Management: Build and maintain strong, collaborative relationships with payers and internal stakeholders.
  • Market Awareness: Stay informed on innovative reimbursement methodologies, including bundled payments and performance-based incentives.
  • Claims Resolution: Draft and facilitate claims settlement agreements as needed.

Requirements:

  • Education: Bachelor's degree in Health Administration, Business, Finance, or a related field required.

Experience:

  • 3-5 years of progressive leadership experience in healthcare.
  • Preferred background in Academic Medical Centers, Multi-Hospital Health Systems, or Managed Care Organizations (MCOs).
  • Demonstrated expertise in healthcare analytics and medical economic modeling.

Compensation: The estimated annual salary for this position is $115,000-$145,000, depending on experience and qualifications.



  • Oklahoma City, Oklahoma, United States Merraine Group Full time

    Payer Relations Director OpportunityWe are looking for a skilled Payer Relations Director to join our team at Merraine Group. This exciting role involves building and maintaining strong, collaborative relationships with payers and internal stakeholders.Key Responsibilities:Negotiate and execute contracts to meet financial goals and operational...


  • Oklahoma City, Oklahoma, United States Merraine Group Full time

    We are seeking an experienced Strategic Payer Relations Manager to join our team at Merraine Group. In this critical role, you will be responsible for negotiating and executing commercial, government, and value-based payer contracts to drive financial outcomes and ensure compliance.The ideal candidate will have a strong understanding of hospital and...


  • Oklahoma City, Oklahoma, United States Merraine Group Full time

    At Merraine Group, we are seeking a seasoned Healthcare Contracting Professional to join our team as the Manager of Managed Care Contracting. This critical role involves negotiating and executing commercial, government, and value-based payer contracts to drive financial outcomes and ensure compliance.The ideal candidate will have 3-5 years of progressive...


  • Oklahoma City, Oklahoma, United States Superior Contracting & Maintenance Full time

    Job Title: HVAC Systems SpecialistCompany Overview:Superior Contracting & Maintenance is a reputable company with 14 years of experience in providing top-notch maintenance services to clients. Our commitment to delivering clear communication, quality repairs, and timely services has earned us a reputation for excellence in the industry.Estimated Salary:...


  • Oklahoma City, Oklahoma, United States Oklahoma Heart Hospital Full time

    **Overview**\Oklahoma Heart Hospital is a leader in cardiac care, serving the state and nation with excellence. As a Patient Care Coordinator - Utilization Review Specialist, you will play a vital role in ensuring our patients receive the best possible care.\Responsibilities:\\Coordinate comprehensive patient care services to promote effective resource...


  • Oklahoma City, Oklahoma, United States Healthcare Partners Investments Full time

    Healthcare Partners Investments is seeking a Medical Claims Specialist to join our team. As a key member of our revenue cycle department, you will play a critical role in ensuring timely and accurate reimbursement from third-party carriers.We are looking for an experienced professional with a strong background in medical billing and claims management. Your...


  • Oklahoma City, Oklahoma, United States Robinson Aviation (RVA), Inc. Full time

    Job DescriptionWe are seeking a highly skilled Contract Administration Specialist to join our team at Robinson Aviation (RVA), Inc. This role involves managing daily contract activities, ensuring compliance with government regulations, and providing exceptional customer service.Responsibilities:Manage daily contract tasks, including processing new contracts...


  • Oklahoma City, Oklahoma, United States Robinson Aviation (RVA), Inc. Full time

    At Robinson Aviation (RVA), Inc., we are seeking a highly skilled Airline and Government Contract Specialist to join our team. The ideal candidate will have a deep understanding of government contracting rules and regulations, as well as experience in managing complex contracts.About the Role:The successful candidate will oversee contract administration...


  • Oklahoma City, Oklahoma, United States Prescient Edge Full time

    Job Summary:Prescient Edge is seeking an experienced Government Contracting Specialist to join our team. The successful candidate will have a strong background in contract management and logistics, with a minimum of eight years of experience working in Government. A TS/SCI security clearance is required.About Us:We are a global operations and solutions...


  • Oklahoma City, Oklahoma, United States MedPro Healthcare Staffing Full time

    Job Opportunity: Step Down Registered Nurse with MedPro Healthcare StaffingWe are currently recruiting for a skilled Nurse Contract Specialist to work as a Step Down Registered Nurse in Oklahoma City, Oklahoma. This exciting opportunity is available for a 13-week contract, providing a chance to enhance your skills and expand your professional...


  • Oklahoma City, Oklahoma, United States One Therapy Network Full time

    Job OverviewWe are seeking a highly motivated and experienced Pediatric Occupational Therapist to join our team at One Therapy Network. As a contract Occupational Therapist, you will play a vital role in providing high-quality therapy services to our pediatric patients and their families.About the RoleThis is a contract position performing OT evaluations at...


  • Oklahoma City, Oklahoma, United States SOS International LLC Full time

    Job DescriptionThe successful candidate for this Contract Support Specialist position will be responsible for assisting in the coordination of planning, programming, development, scheduling, and implementation of various intelligence support functions. With a strong background in using basic computer applications, including MS Office and current information...


  • Oklahoma City, Oklahoma, United States Med-Metrix Full time

    **About the Role:**We are looking for a highly motivated Medical Practice Collections Specialist to join our team at Med-Metrix. As a key member of our AR team, you will be responsible for resolving insurance claims in a timely manner and supporting our representatives in their daily tasks.**Responsibilities Include:**Providing ongoing support to AR...


  • Oklahoma City, Oklahoma, United States Ardor Health Solutions Full time

    Ardor Health Solutions, a renowned medical staffing business, is seeking a skilled Cardiology specialist to join our team on a travel contract basis.Job OverviewThis is a full-time travel contract position that requires the candidate to work in a hospital setting, utilizing their expertise in Cardiology to provide exceptional patient care.Key...


  • Oklahoma City, Oklahoma, United States Healthcare Partners Investments Full time

    Job SummaryWe are looking for an experienced Billing Specialist to join our team at Healthcare Partners Investments. In this role, you will be responsible for preparing and submitting claims, reviewing and resolving claims, and providing exceptional customer service. The ideal candidate will have strong knowledge of healthcare billing processes, including...


  • Oklahoma City, Oklahoma, United States Prescient Edge Full time

    Job OverviewPrecient Edge is seeking a highly skilled Lead Administrative Specialist - Government Contracts to lead our logistical efforts. As a trusted advisor, you will guide our team in delivering exceptional service to our clients while fostering a culture of excellence within the organization.ResponsibilitiesKey responsibilities will include managing...


  • Oklahoma City, Oklahoma, United States Ardor Health Solutions Full time

    Ardor Health Solutions is a leading medical staffing company that provides high-quality travel nursing positions to experienced professionals. Our current opportunity is for a Pediatric Intensive Care Unit (PICU) nurse specialist to join our team in Oklahoma City, OK.We are seeking a skilled and dedicated nurse with a minimum of two years of experience in...


  • Oklahoma City, Oklahoma, United States Oklahoma Heart Hospital Full time

    Company Overview">Oklahoma Heart Hospital is committed to delivering exceptional patient care and setting the standard for excellence in the industry. Our team of professionals works collaboratively to ensure that our patients receive the best possible treatment. We are dedicated to innovation, using cutting-edge technology and evidence-based practices to...


  • Oklahoma City, Oklahoma, United States Merraine Group Full time

    About the JobMerraine Group is seeking a seasoned Managed Care Professional Lead to drive financial outcomes, ensure compliance, and foster strong payer relationships. As a key member of our team, you will negotiate and implement commercial, government, and value-based payer contracts.Responsibilities:Negotiate and execute contracts to meet financial goals...


  • Oklahoma City, Oklahoma, United States Merraine Group Full time

    Merraine Group is committed to empowering youth and families to live safely, independently, and productively within their communities. As the Manager of Managed Care Contracting, you will play a pivotal role in negotiating and implementing commercial, government, and value-based payer contracts to support our mission.This position requires a strategic...