Payer Contracting Manager, Transplant Program

Job Description:

The Payer Contracting Manager, Transplant Program is responsible for the strategic management of payer and specialty network relationships that support Intermountain Health's transplant programs. This role brings expertise in transplant reimbursement, specialty network contracting, and complex payer negotiations, partnering closely with business development and operational leaders to expand transplant outreach agreements, strengthen referral networks, and drive program growth.

The position oversees all aspects of assigned contracts, including negotiation support, contract and relationship management, reimbursement issue resolution, rate optimization, and cross-functional collaboration. This role serves as the primary contracting lead for transplant-related payer agreements across Intermountain Health.

This position can be performed remotely with business travel as-needed. Intermountain Health maintains employment registration in Utah, Idaho, Nevada, Colorado, Montana, and Wyoming. Candidates in other locations may be considered. Currently, we are not hiring remote workers in the following states: CA, CT, HI, IL, MA, MN, NY, PA, RI, VT, and WA. Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings.

Essential Functions

• Manages all aspects of assigned payer relationships, including supporting contract language negotiation and management, rate and methodology research and negotiation, dispute resolution, and relationship management.
• Maintains ongoing expertise of all assigned contracts, including contract/amendment language and structure, rates, methodologies, and contracted providers/facilities.
• Ensures all contract language, documentation, negotiation, payment rate, payment methodology, contract storage, and escalated contract issues follow Payer Contracting standard practices.
• Represents Payer Contracting and Intermountain Health in key relationships, including leading Joint Operating Committees.  
• Establishes and maintains effective long-term relationships with highly aligned payers.
• Coordinates with Finance and Revenue Cycle leadership for the implementation of risk-based contracting, and proactive care, strategies and initiatives.
• Coordinates with Legal and Compliance to ensure contract accuracy, regulatory compliance, and language consistency.
• Provides leadership and mentorship to Payer Contracting Managers.

Skills

• Contracting Strategies
• Healthcare Contracts
• Negotiations
• Payer Contracting
• Proactive Care
• Risk-based Contracting
• Relationship Management
• Managed Care
• Legal Practices
• Leadership

Minimum Qualifications

• Experience leading and supporting complex negotiations. 
• Experience in a professional role that requiring effective verbal and written communication to present advanced topics in a clear, concise, polished, and professional manner.
• Demonstrated ability to synthesize extensive amounts of data into clear and concise summaries without sacrificing material details.
• Experience leading teams, including cross-functional teams.
• Demonstrated experience mentoring teams and caregivers.

Preferred Qualifications

• Experience negotiating complex payer agreements, transplant center of excellence arrangements, specialty network contracts, and/or other advanced reimbursement models, with a strong understanding of case rates, bundled payments, carve out agreements, and high acuity service reimbursement.

Additional Information

• This is an exempt, full-time position. Pay offers are determined by prior years of relevant experience within the established pay range.

• In addition to the annual salary, to show our commitment to you and assist with your transition,, we may offer a sign-on and relocation bonus when applicable. With this position, you are eligible to participate in the Annual Pay for Performance (AP4P) Plan. This plan enables Intermountain Health to provide leaders with an additional performance compensation opportunity. The AP4P award opportunities are calculated as a percentage of your base salary. Awards are paid out based on attainment of selected Board-approved goals. 

Physical Requirements

• Ability to travel on a frequent basis to negotiate contracts with payers.
• Ongoing need for employee to see and read information, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
• Frequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and underst