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Payer Relations Manager Jobs (NOW HIRING)

Uw

PAYER RELATIONS SPECIALIST - UWMEDICINE

Seattle, WA · Remote

$90K/yr

Support payer relations operations through research, analysis, and coordination of managed care contracting activities. * Assist with drafting, reviewing, and maintaining contract documents and ...

AnewHealth

OR

AnewHealth is one of the nation's leading pharmacy care management companies that specializes in ... Job Details The Director, Strategic Payer Relations is a leader responsible for managing and ...

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How much do payer relations manager jobs pay per year?

As of Jun 8, 2026, the average yearly pay for payer relations manager in the United States is $80,705.00, according to ZipRecruiter salary data. Most workers in this role earn between $50,500.00 and $105,500.00 per year, depending on experience, location, and employer.

How does a Payer Relations Manager typically collaborate with other departments to ensure successful contract negotiations?

As a Payer Relations Manager, you will frequently work cross-functionally with departments such as finance, legal, and clinical operations to prepare for and execute contract negotiations. Collaboration often involves gathering data on service costs, reviewing compliance requirements, and aligning the organization’s strategic goals with payer expectations. Effective communication and coordination are essential, as you'll need to ensure that all stakeholders are informed and that negotiated terms can be operationalized smoothly across teams. This collaborative environment helps drive successful outcomes and fosters a unified approach to payer relationships.

What are Payer Relations Managers?

Payer Relations Managers are professionals who serve as the primary point of contact between healthcare providers, such as hospitals or physician groups, and insurance companies or other payers. Their main responsibility is to negotiate contracts, resolve disputes, and ensure that reimbursement processes run smoothly. They analyze payer policies, advocate for favorable terms, and work to improve the overall relationship between the provider organization and payers. This role is critical in maintaining financial stability for healthcare organizations and ensuring patients can access covered services.

What are the key skills and qualifications needed to thrive as a Payer Relations Manager, and why are they important?

To thrive as a Payer Relations Manager, you need expertise in healthcare reimbursement, contract negotiation, and a solid understanding of payer-provider dynamics, usually backed by a degree in healthcare administration or a related field. Familiarity with contract management systems, claims processing software, and regulatory compliance tools is essential. Strong communication, analytical thinking, and relationship-building skills help negotiate favorable terms and resolve conflicts effectively. These skills are crucial for optimizing payer agreements, ensuring financial sustainability, and fostering positive partnerships within the healthcare ecosystem.

What is the difference between Payer Relations Manager vs Payer Account Executive?

AspectPayer Relations ManagerPayer Account Executive
Primary FocusManaging relationships with payers, negotiating contracts, and ensuring payer satisfactionAcquiring new payers, presenting plans, and closing contracts
Required CredentialsBachelor's degree, experience in healthcare or insurance, strong communication skillsBachelor's degree, sales experience, knowledge of insurance products
Work EnvironmentHealthcare organizations, insurance companies, or managed care settingsSales offices, healthcare providers, insurance firms
Industry UsageCommonly used in healthcare management and payer relationsCommonly used in sales and business development within healthcare

The Payer Relations Manager focuses on maintaining and strengthening existing payer relationships, while the Payer Account Executive primarily works on acquiring new payers and expanding the payer network. Both roles require healthcare or insurance knowledge but differ in their core responsibilities and daily activities.

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Payer Relations Manager jobs near you
Infographic showing various Payer Relations Manager job openings in the United States as of May 2026, with employment types broken down into 40% Full Time, 54% Part Time, 2% Temporary, and 4% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $80,705 per year, or $38.8 per hour.
Payer Relations Specialist

Payer Relations Specialist

Springfield Clinic

Springfield, IL • On-site

Full-time

Posted 5 days ago

Springfield Clinic rating

6.6

Company rating: 6.6 out of 10

Based on 57 frontline employees who took The Breakroom Quiz

558th of 869 rated healthcare providers

Job description

The Payer Relations Specialist assists with the administrative oversight of payer contracts on behalf of Springfield Clinic. Works closely with Payer Relations Manager to maintain the details of participating network contracts. Provides internal support so that contractual obligations can easily be met while enhancing revenue and patient access and provides general assistance and support to the Director of Managed Care and Payer Relations Manager.

Job Relationships

Reports to the Payer Relations Manager

Principal Responsibilities

  • Collaborates directly with the Director of Managed Care and Payer Relations Manager to support all payer relations business needs.
  • Possess in-depth knowledge and understanding of payer's guidelines, contractual terms, and the processing of Springfield Clinic claims to provide direction and guidance to all internal departments.
  • Responds to payer contract questions as well as benefit and billing questions
  • Coordinates with revenue cycle, quality management, practice operations and credentialing teams to ensure that all payer contractual obligations are met.
  • Rectifies day to day issues for provider service representatives and others within practice operations
  • Receive, research, and perform service recovery as needed
  • Maintains relationships with provider relations representatives with all contracted managed care plans.
  • Identifies issues to discuss in recurring payer meetings.
  • Partner with patient accounting and compliance colleagues to resolve individual cases of improper reimbursement and identify trends.
  • Provide verbal and written communication to all applicable Springfield Clinic practice operations, ancillary, and billing teams related to updates of payer information such as payer provider manuals, provider bulletins and other notices relating to eligibility, covered services, pre-authorization requirements, coding and claim requirements, appeal processes, etc.
  • Analyze and coordinate execution of single case agreements and requested contracts including communications with other teams.
  • Facilitate meetings, display willingness to make decisions within scope of responsibility, and include the appropriate people in the decision-making process.
  • Utilize critical thinking and problem-solving skills when addressing payer, office, and provider concerns
  • Respond promptly to client needs and solicit feedback to improve service, meet commitments and provide follow-up within a timely manner.
  • Develop training aids and train staff on the use of online portals and other tools utilized to obtain prior authorizations in compliance with all payer plans to maximize efficiency
  • Build strong relationships and instill confidence and trust at all levels of the organization including providers.
  • Attends workshops, seminars, and other training programs for educational growth.
  • Comply with the Springfield Clinic incident reporting policy and procedures.
  • Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
  • Provide excellent customer service and adhere to Springfield Clinic's Code of Conduct and Ethics Standards.
  • Perform other job duties as assigned.

Education/Experience

  • Associates Degree in business, healthcare administration, or equivalent experience is required.  Bachelors degree is preferred.

Knowledge, Skills and Abilities

  • Conceptual knowledge of principles and practices of healthcare related payer relations/contracts.
  • Strong communication skills are required
  • Ability to manage multiple tasks and work in a fast-paced environment is required.
  • Must be detail oriented and able to deliver a high level of accuracy.
  • Must be proficient in all MS Office applications, including Excel, Access, PowerPoint and Word.
  • Ability to define problems, collect data, establish facts, and draw valid conclusions.
  • Ability to effectively present information and respond to questions from staff and management across the Clinic.
  • Must consistently exercise discretion and sound judgement

Working Environment

  • This job operates in a professional office environment.
  • Routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
  • Occasional travel possible.

PHI/Privacy Level

HIPAA1

What Springfield Clinic employees say

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Benefits

Hours and flexibility

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