Apply on Employer Site

Metro Vein Centers · 23 hours ago

Payer Relations Manager

United States

Full-time

Remote

Mid, Senior Level

5+ years exp

Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments. They are seeking a Manager of Payer Relations to oversee payer contracts and drive operational efficiency across multiple clinics while collaborating with various departments to enhance revenue performance.

Health CareHospitalMedicalWellness

Responsibilities

Oversee and maintain all payer contracts, fee schedules, and amendments across multiple states and sites, ensuring accuracy, compliance, version control, and integrity within the organization’s contract management and modeling systems

Own the contract management and modeling function, including system governance, timely updates to reimbursement methodologies, fee schedules, and contract term dates, and support payer negotiations through financial modeling, benchmarking, and impact analyses

Interpret payer contract terms, reimbursement methodologies, and state-specific requirements, translating them into standardized, scalable operational guidance to support consistent execution across markets

Serve as the primary cross-functional and external liaison to Revenue Cycle, Finance, Credentialing, Operations, and payer partners, leading resolution of issues related to claims, denials, authorizations, credentialing, system configuration, and payment variances

Monitor payer performance, reimbursement trends, and policy changes; proactively identify revenue leakage, operational risk, and improvement opportunities, and develop dashboards, KPIs, and reporting to track performance, denial trends, and contract profitability

Lead cross-functional communication, education, and process standardization related to payer requirements, contract interpretation, and best practices, establishing SOPs to support growth, new site launches, and expansion into new markets

Qualification

Payer relationsContract managementRevenue cycle managementAnalytical skillsContract modeling toolsTableauValue-based careCommunication skillsRelationship-buildingProject management

Required

Bachelor's degree in Healthcare Administration, Business, Finance, or related field

5–8 years of experience in managed care operations, payer relations, contracting, or revenue cycle within a multi-site or multi-state healthcare organization

In-depth knowledge of commercial payer structures, Medicare Advantage, and Medicaid fee-for-service/managed care variations across states

Strong analytical skills with the ability to interpret reimbursement terms and claims data

Proficiency with contract modeling tools, RCM systems, Tableau, and analytics platforms

Excellent communication and relationship-building skills across internal and external stakeholders

Demonstrated ability to manage multiple projects across regions with competing priorities