Payor Contract Manager
4 weeks ago
About CLS Health
CLS Health is a growing healthcare system in Houston, Texas that is taking a different approach to healthcare. We are a physician-led healthcare group that focuses on providing patients with holistic, multispecialty care. We're a dynamic team on a mission to provide better healthcare options for Houstonians
Role Overview:
We are seeking a highly skilled and motivated Payor Contracting Manager to join our team. The Payor Contracting Manager will be responsible for negotiating, managing, and optimizing payor contracts to ensure favorable terms and conditions for our organization. This role requires a strategic thinker with excellent negotiation skills and a deep understanding of the healthcare industry and payor dynamics.
Key Responsibilities:
- Negotiate and manage payor contracts, ensuring terms are favorable and aligned with the organization’s financial and operational goals.
- Develop and maintain relationships with payors, including insurance companies, managed care organizations, and government payors.
- Analyze contract performance and identify opportunities for improvement and optimization.
- Collaborate with internal stakeholders, including finance, operations, and clinical teams, to align contract terms with organizational objectives.
- Monitor regulatory and industry changes that may impact payor contracts and reimbursement rates.
- Prepare and present reports on contract performance, trends, and strategic recommendations to senior management.
- Ensure compliance with all relevant laws, regulations, and organizational policies in the negotiation and management of payor contracts.
- Act as a liaison between the organization and payors to resolve contract-related issues and disputes.
Qualifications:
- Bachelor’s degree in Healthcare Administration, Business Administration, or a related field (Master’s degree preferred).
- Minimum of two years of experience in payor contracting, healthcare finance, or a related role.
- Strong understanding of healthcare reimbursement methodologies, payor contracting principles, and regulatory requirements.
- Excellent negotiation, analytical, and problem-solving skills.
- Ability to build and maintain relationships with internal and external stakeholders.
- Strong communication and presentation skills, with the ability to convey complex information clearly and concisely.
- Proficiency in Microsoft Office Suite and contract management software.
Benefits:
- Competitive salary
- Health, dental, and vision insurance
- Retirement savings plan
- Paid time off
- Professional development opportunities
Why Join Us:
- Be part of a company that is making difference in patient's lives.
- Work in a collaborative environment where creativity and innovation are encouraged.
- Competitive salary and benefits package.
- Opportunities for professional growth and development.
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