Payor Relations Manager/Senior Analyst (Healthcare) - Part Time 1099

Payor Relations Manager/ Director (Healthcare) - Part Time 1099
 
Are you a seasoned professional in the healthcare industry with a passion for strategic negotiation and analytics? Join our dynamic team as a Payor Relations Manager/Senior Analyst, where you will play a crucial role in shaping and optimizing our payer relationships.   

  
Key Responsibilities:   

• Payer Contracting Negotiation: Lead negotiations with insurance companies to secure favorable payer contracts, ensuring optimal terms for both parties.   

• Analyzes the potential impact of contract re‐negotiations by building proposed rates into the Contract Management System and modeling the financial impact.  

• Analytical Platforms: Spearhead the development of analysis to build a compelling business case to justify rate increases with Payers.   

• Business Case Development: Utilize your experience in building robust business cases to support and guide key organizational decisions.   

• Analytics: Oversee the development and implementation of analytics strategies to derive actionable insights from complex healthcare data.   

• Relationship Management: Build and maintain relationships with key payer stakeholders and organizations   

• Negotiation with Insurance Companies: Leverage your relationships and negotiation skills to negotiate rate increases with insurance companies, ensuring mutually beneficial agreements for all stakeholders.  

• Reimbursement research  

• Collect, organize and interpret reimbursement data for CMS1500 and UB for billing.  

• Research and coordinates with compliance for Revenue Cycle requirements for facility and non-facility operations.  

• Provide feedback to Revenue Cycle for opportunities at financial improvement.  

• Analyze payor behavior trends across the nation on a facility/non facility and state‐wide scale.  

• Examine outside data from prospective clients and provide analysis to the Business Development/ Sales Team.  

Skills: 

• Contract Negotiation: A strong understanding of negotiating reimbursement rates, pricing structures, and terms with payers is crucial. Experience in handling contract modifications, renewals, and ensuring compliance with legal and regulatory requirements is also important. 

• Financial Acumen: Understanding financial models, payment methodologies (such as fee-for-service, capitation, value-based care), and being able to analyze reimbursement data to optimize revenue for healthcare providers. 

• Healthcare Knowledge: Familiarity with healthcare laws, payer systems (such as Medicare, Medicaid, commercial insurance), and the regulatory environment surrounding reimbursement. 

• Data Analysis: Comfort with data to assess contract performance, payer trends, and outcomes is often required. Basic proficiency in Excel, databases, or other analytics tools. 

• Communication and Presentation Skills: Strong verbal and written communication skills are necessary to articulate contract terms and negotiate effectively.  

• Relationship Management: Building relationships with payer representatives is key to successful negotiations and ongoing collaboration. 

• Problem-Solving: The ability to identify challenges in payer-provider contracts and work proactively to resolve them. 

Qualifications:   

• Education: A bachelor’s degree in healthcare administration, business, finance, or a related field is common. An advanced degree such as an MBA or MHA is not required but can be beneficial. 

• Certifications: Certified Healthcare Financial Professional (CHFP) or Certified Professional in Healthcare Management (CPHM) will be beneficial. 

• Minimum of 3-5 years of experience in payer contracting, with a focus on negotiation and analytics.   

• Analytical and able to create in depth analysis using Excel, Power BI or Tableau 

• Strong experience in crafting persuasive & analytical business cases in the form of a presentation deck.   

Location: Chicago, IL  
Part Time 1099 
Work Set up - Remote  

If you are a strategic thinker with a passion for negotiating and a strong background in analytics, we invite you to bring your expertise to our team. Apply now by submitting your resume to ronel@neolytix.com with the subject line "Payor Relations Manager/Senior Analyst"