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Payor Contracting Specialist

2 months ago

Denver, Colorado, United States SonderMind Careers Full time
About the Role

SonderMind Careers is seeking a highly skilled Payor Contracting Specialist to join our growing team. As a key member of our managed care contracting department, you will be responsible for managing and supporting the administrative and operational functions of our payor contracting efforts, both regionally and nationally.

Key Responsibilities
  • Market Analysis and Research
    • Conduct in-depth analysis of payor markets on a state-by-state basis to identify trends and opportunities.
    • Develop and maintain a comprehensive understanding of payor mix, reimbursement trends, and product offerings.
  • Payer Relationship Management
    • Develop and maintain strong relationships with payor partners, ensuring effective communication and responsiveness to their needs.
    • Identify and document key decision-makers and chain of command within payor organizations.
  • Contract Life Cycle Management
    • Implement and manage the contract life cycle process, including communication and follow-up with payors to secure new in-network agreements.
    • Load payor contracts into our designated contract management database and track red-line agreements.
    • Prepare agreements for signature and facilitate internal new payor announcements.
  • Payer Contract Rate Management
    • Load new payor rates into our designated database with accuracy and attention to detail.
    • Proactively review fee schedules against insurance allowed amounts to ensure compliance.
  • Leadership and Collaboration
    • Lead payor account joint operating committee calls, setting up recurring meetings and preparing agendas.
    • Coordinate follow-up actions and create PowerPoint presentations to drive the meeting.
  • Issue Resolution and Facilitation
    • Resolve contractual discrepancies, reimbursement issues, and credentialing delays in a timely and effective manner.
  • Strategic Partnerships and Support
    • Support the development of new internal strategic partnerships and offerings.
  • Documentation and Database Management
    • Maintain accurate and up-to-date documentation and organize our payor contracting department databases, shared drives, and other tools.
What We're Looking For
  • A minimum of 2 years of experience in payor contracting or a related field.
  • A Bachelor's degree or equivalent experience.
  • Strong analytical and problem-solving skills, with attention to detail and ability to work independently.
  • Excellent communication and interpersonal skills, with the ability to build strong relationships with payor partners.
  • Experience working on the payor side and/or provider side, preferably in payor contracting or managed care settings.
  • Strong data management skills and proficiency in Microsoft and Google platforms.
Benefits

SonderMind Careers offers a competitive salary range of $70,000-80,000 per year, as well as a comprehensive benefits package, including:

  • A commitment to fostering flexible hybrid work arrangements.
  • A generous PTO policy with a minimum of three weeks off per year.
  • Free therapy coverage benefits to ensure our employees have access to the care they need.
  • Competitive Medical, Dental, and Vision coverage with plans to meet every need.
  • Employer-paid short-term, long-term disability, life & AD&D insurance.
  • Eight weeks of paid Parental Leave.
  • 401K retirement plan with 100% matching.
  • Travel opportunities and professional development support.