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Payer Relations Manager Jobs in Michigan (NOW HIRING)

Pwc

Payer Quality Consultant, Director

Detroit, MI · On-site

$155K - $410K/yr

Industry/Sector Health Services Specialism Operations Management Level Director & Summary The ... relations. Your role is crucial in driving business growth, shaping the direction of client ...

Integra Partners

Sales Director

Troy, MI · On-site +1

$150K - $150K/yr

Integra's Payer Relations + Business Development team is responsible for new business generation, and ongoing success of the Company's Payer account portfolio, ensuring relationship management and ...

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All JobsPayer Relations JobsPayer Relations Manager JobsPayer Relations Manager Jobs in Michigan

Payer Relations Manager information

See Michigan salary details

$24.4K

$70.3K

$122.5K

How much do payer relations manager jobs pay per year?

As of Aug 25, 2026, the average yearly pay for payer relations manager in Michigan is $70,342.00, according to ZipRecruiter salary data. Most workers in this role earn between $44,000.00 and $92,000.00 per year, depending on experience, location, and employer.

What is a payer relations manager?

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.

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 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.

What are the most commonly searched types of Payer Relations jobs in Michigan?

The most popular types of Payer Relations jobs in Michigan are:

What are popular job titles related to Payer Relations Manager jobs in Michigan?

For Payer Relations Manager jobs in Michigan, the most frequently searched job titles are:

What job categories do people searching Payer Relations Manager jobs in Michigan look for?

The top searched job categories for Payer Relations Manager jobs in Michigan are:

What cities in Michigan are hiring for Payer Relations Manager jobs?

Cities in Michigan with the most Payer Relations Manager job openings:

Payer Relations Manager jobs near you
Infographic showing various Payer Relations Manager job openings in Michigan as of August 2026, with employment types broken down into 100% Full Time. Highlights an 73% In-person, and 27% Remote job distribution, with an average salary of $70,342 per year, or $33.8 per hour.

PBM Partnerships & Payer Relations Manager

Insight

Flint, MI • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 16 days ago

Job description

Insight Health System is a physician-led organization focused on advancing excellence in healthcare and community well-being. Our expertise is in transforming distressed hospitals into stable, patient-centric care that is second to none. With a track record for innovation in healthcare, research and development, Insight Health System provides the communities we serve with world-class healthcare services at the forefront of medical technology. Our network currently includes a portfolio of entities encompassing six acute care hospitals (three of which are nonprofit), six surgery centers, 28 clinics, 580 physicians, 10 unions, and 4,200 employees. Collectively, Insight Health System hospitals provide nearly 100,000 patient days annually.
Position Overview
We are seeking a proactive, relationship-driven PBM Partnerships & Payer Relations Manager to serve as the primary point of contact for Pharmacy Benefit Managers (PBMs), third-party administrators (TPAs), brokers, and self-funded employer groups. This role is responsible for building new partnerships, strengthening existing relationships, supporting contract execution, ensuring operational accuracy, and driving network growth across all payer and PBM channels. The ideal candidate excels at communication, problem-solving, and business development within the pharmacy or healthcare benefits ecosystem.
Benefits:
  • Comprehensive health, dental, and vision insurance
  • Paid time off: vacation, holidays, and sick leave
  • 401(k) with employer match (immediate vesting; eligibility begins after 3 months)
  • Employer - paid short - and long - term disability, basic life insurance
  • Voluntary coverages: accident, critical illness, hospital indemnity, AD&D, etc.

Key Responsibilities:
PBM Partnership Management
  • Serve as the main liaison for all PBM partners, contractors, TPAs, and associated vendors.
  • Manage onboarding, implementations, and ongoing communication to ensure alignment and strong operational performance.
  • Oversee contract execution, version control, and escalation resolution with external partners.
  • Proactively step in to assist with prior authorizations or operational duties as needed to ensure exceptional service continuity.
  • Maintain a clear understanding of PBM reimbursement strategies, plan designs, MAC pricing, and specialty pharmacy dynamics.
  • Step in to assist with PAs or operations during high-volume periods or staffing gaps.

Self-Funded Employer Network Development
  • Build new relationships with self-funded employers, brokers, benefits consultants, and employer coalitions.
  • Identify opportunities for employers to utilize the pharmacy as a preferred or direct-to-employer solution (specialty savings, infusion savings, carve-outs).
  • Present pharmacy value propositions, cost-savings models, and service offerings to employer groups.
  • Support the execution of direct-to-employer agreements and develop customized employer workflows.

Payer & Network Growth
  • Drive expansion into new PBM networks, payer groups, and employer health plans.
  • Research and pursue opportunities to improve reimbursement rates or negotiate favorable contract terms.
  • Track market trends, competitive pricing, and plan changes influencing pharmacy performance.
  • Strengthen ties with existing PBM and payer partners to secure long-term relationships.

Operational & Contract Coordination
  • Troubleshoot operational issues, adjudication errors, reimbursement discrepancies, and network constraints.
  • Collaborate with internal teams (legal, finance, operations, pharmacy) to ensure contractual accuracy and workflow alignment.
  • Maintain oversight of contract renewals, amendments, compliance obligations, and key dates.
  • Support renegotiation efforts by preparing comparisons, contract reviews, and partner summaries.

Performance Monitoring & Reporting
  • Track reimbursement patterns, adjudication behaviors, specialty margins, and PBM performance metrics.
  • Generate internal reporting to evaluate partnership effectiveness and financial outcomes.
  • Identify opportunities to optimize pricing strategies, improve patient access, and enhance profitability.

Relationship Building & Strategic Development
  • Cultivate strong, trust-based relationships with PBM executives, employer decision-makers, consultants, and industry partners.
  • Represent the organization at meetings, conferences, and strategic discussions.
  • Identify emerging opportunities for collaboration, market expansion, or product/service enhancement.

Required Qualifications
  • Bachelor's degree in Business, Healthcare Administration, Pharmacy, or a related field.
  • Experience working with PBMs, payers, networks, benefits administrators, or pharmacy operations.
  • Strong communication, negotiation, and relationship-management skills.
  • Ability to manage contracts, escalations, timelines, and multi-stakeholder relationships.
  • Strong analytical thinking, problem-solving skills, and organizational abilities.

Preferred Qualifications
  • Prior experience working directly with PBMs, TPAs, or self-funded employer groups.
  • Experience in specialty pharmacy, infusion services, or pharmacy network contracting.
  • Working knowledge of claim adjudication, reimbursement structures, MAC lists, spread pricing, and DIR fee models.
  • Experience building direct-to-employer pharmacy programs or benefit carve-out models.
  • Familiarity with value-based pharmacy programs, outcomes reporting, and data-driven performance metrics.
  • Strong understanding of healthcare contracting, payer policies, and benefits administration.
  • Ability to interpret contract terms, fee schedules, and reimbursement methodologies.
  • Experience presenting pharmacy solutions or savings programs to employers, payers, or consultants.
  • Existing relationships with PBMs, benefit brokers, employer groups, or industry partners is a major plus.

Insight is an equal opportunity employer and values workplace diversity!

Apply