Neolytix · 8 hours ago
Payor Relations Manager/Senior Analyst (Healthcare) - Remote
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Responsibilities
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.
Spearhead the development of analysis to build a compelling business case to justify rate increases with Payers.
Utilize your experience in building robust business cases to support and guide key organizational decisions.
Oversee the development and implementation of analytics strategies to derive actionable insights from complex healthcare data.
Build and maintain relationships with key payer stakeholders and organizations
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.
Qualification
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Required
Bachelor's degree in healthcare administration, Business, or a related field
Minimum of 3-5 years of experience in payer contracting, with a focus on negotiation and analytics
Proven track record in building and implementing analytical platforms
Strong experience in crafting persuasive business cases
In-depth knowledge of healthcare analytics and negotiating with insurance companies
Preferred
Master's degree