ZipRecruiter

Log In

1

Payer Relations Jobs (NOW HIRING)

Helms & Company Inc

Payer Contracts Manager

Concord, NH · On-site

$89K - $119K/yr

Significant experience (typically 5+ years) in managed care, healthcare payer relations, provider contracting, or health insurance operations. * Deep understanding of how commercial insurers function ...

Allina Health

$52.24 - $72.28/hr

No weekends Oversees proper payer contracting, payer relations, and revenue management for health system pharmacy. Ensures contracting requirements are met and provides analysis, problem resolution ...

next page

Showing results 1-20

All JobsPayer Relations Jobs

Payer Relations information

See salary details

$29K

$67.4K

$114.5K

How much do payer relations jobs pay per year?

As of Jun 29, 2026, the average yearly pay for payer relations in the United States is $67,404.00, according to ZipRecruiter salary data. Most workers in this role earn between $46,000.00 and $83,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Payer Relations position, and why are they important?

To thrive as a Payer Relations professional, you need a solid understanding of healthcare reimbursement, contract negotiation, and managed care principles, often supported by a degree in healthcare administration or a related field. Experience using contract management software, CRM systems, and knowledge of healthcare regulations such as HIPAA and Medicare/Medicaid requirements is highly beneficial. Strong interpersonal skills, strategic problem-solving, and effective communication make individuals stand out in collaborating with payers and internal teams. These qualities are essential for building productive partnerships, resolving disputes, and ensuring favorable reimbursement outcomes for healthcare organizations.

What does payer relations mean?

Payer relations is a role that involves managing interactions between healthcare providers and insurance payers to ensure accurate billing, claims processing, and reimbursement. It requires knowledge of insurance policies, coding, and compliance, often utilizing tools like claims management systems. Strong communication and negotiation skills are essential for maintaining effective payer partnerships.

What is a payer relations job description?

A payer relations job involves managing communication and relationships with insurance payers to ensure proper reimbursement for healthcare services. Responsibilities include negotiating contracts, resolving billing issues, and maintaining compliance with healthcare regulations, often requiring knowledge of insurance policies and healthcare billing systems.

What are some common challenges faced by Payer Relations professionals?

Payer Relations professionals often encounter challenges such as navigating complex contract negotiations, resolving reimbursement disputes, and staying current with changing healthcare regulations. They must balance the needs of their organization with the requirements and policies of insurance companies, which can sometimes lead to lengthy discussions or intricate problem-solving. Additionally, frequent collaboration with billing, compliance, and clinical teams is necessary to ensure accurate information is shared and issues are resolved efficiently. These challenges make the role dynamic and rewarding for those who enjoy strategic communication and process improvement.

What jobs pay $10,000 a month without a degree?

In the Payer Relations field, high-paying roles such as senior payer relations managers or healthcare account directors can reach or exceed $10,000 monthly, especially with experience and strong negotiation skills. These positions often require industry knowledge, certifications, and excellent communication abilities but may not always require a formal degree. Compensation varies based on location, company size, and individual expertise.

What is a Payer Relations job?

A Payer Relations job involves managing relationships between healthcare providers and insurance companies (payers) to ensure smooth contract negotiations, reimbursement processes, and compliance with regulatory requirements. Professionals in this role work to optimize payer contracts, resolve disputes, and advocate for favorable terms that support both financial and patient care goals. They also monitor industry trends, policy changes, and reimbursement structures to maintain strong partnerships and operational efficiency. Effective communication, negotiation skills, and a deep understanding of healthcare reimbursement are key to success in this field.

What jobs pay 2000 a day?

In the Payer Relations field, high-paying roles such as senior payer relations managers, healthcare consultants, or executive-level positions can sometimes earn around $2,000 per day, especially with extensive experience, specialized skills, or in consulting roles. These positions often require strong negotiation, healthcare industry knowledge, and certifications, and may involve project-based or contract work with variable pay rates.
More about Payer Relations jobs
What are the most commonly searched types of Payer Relations jobs? The most popular types of Payer Relations jobs are:
What states have the most Payer Relations jobs? States with the most job openings for Payer Relations jobs include:
What job categories do people searching Payer Relations jobs look for? The top searched job categories for Payer Relations jobs are:
Payer Relations jobs near you
Infographic showing various Payer Relations job openings in the United States as of June 2026, with employment types broken down into 97% Full Time, 2% Part Time, and 1% Temporary. Highlights an 86% Physical, 2% Hybrid, and 12% Remote job distribution, with an average salary of $67,404 per year, or $32.4 per hour.
PBM Partnerships & Payer Relations Manager

PBM Partnerships & Payer Relations Manager

Insight

Flint, MI • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 days ago

Insight Enterprises rating

8.5

Company rating: 8.5 out of 10

Based on 19 frontline employees who took The Breakroom Quiz

27th of 206 rated it services

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!

What Insight Enterprises employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply