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Payer Strategy Manager Jobs (NOW HIRING)

Phsorg

Develop and implement a comprehensive managed care strategic and tactical plan with clear ... Represent PHS in payer negotiations, regulatory discussions, and industry forums * Collaborate ...

Smile Brands

Director of Payer Strategy

Overview The Director, Payer Strategy is responsible for leading Smile Brands' payer contracting ... Payer Relationship Management * Develop and maintain productive relationships with assigned payer ...

0090 Presbyterian System Services

WI · On-site

$150 - $180/hr

Develop and implement a comprehensive managed care strategic and tactical plan with clear ... Represent PHS in payer negotiations, regulatory discussions, and industry forums. * Collaborate ...

Action Behavior Centers

$50K - $60K/yr

Position Summary: The Payer Strategy Analyst owns the end-to-end lifecycle of case-by-case ... Act as a liaison between Credentialing and Revenue Cycle Management teams to support resolution of ...

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How much do payer strategy manager jobs pay per year?

As of Aug 30, 2026, the average yearly pay for payer strategy manager in the United States is $124,659.00, according to ZipRecruiter salary data. Most workers in this role earn between $90,000.00 and $157,500.00 per year, depending on experience, location, and employer.

What is a payer strategy manager?

A Payer Strategy Manager is a professional in the healthcare industry responsible for developing and implementing strategies related to health insurance payers, such as insurance companies, government programs, and managed care organizations. Their role involves analyzing market trends, negotiating contracts, and ensuring that products and services align with payer requirements to optimize reimbursement. They often collaborate with sales, marketing, and product teams to support business growth and maintain strong payer relationships. Payer Strategy Managers play a key role in shaping how healthcare organizations interact with payers to maximize access and profitability.

What are the key skills and qualifications needed to thrive as a payer strategy manager?

To thrive as a Payer Strategy Manager, you need expertise in healthcare policy, data analysis, contract negotiation, and a background in business, healthcare administration, or a related field. Familiarity with claims management systems, financial modeling tools, and payer-provider platforms is typically required, along with relevant certifications such as Certified Professional in Healthcare Management (CPHM). Strong analytical thinking, relationship-building, and strategic communication skills help set top performers apart in this role. These capabilities are crucial for developing effective payer strategies, optimizing reimbursement, and maintaining productive partnerships with insurance payers.

What are the primary challenges a payer strategy manager faces when aligning internal teams with payer requirements?

A Payer Strategy Manager often navigates the complex task of bridging internal cross-functional teams, such as sales, medical, and market access, with the evolving requirements of payers. This requires not only an in-depth understanding of payer policies and reimbursement landscapes but also strong communication skills to translate these requirements into actionable strategies. One common challenge is ensuring that all stakeholders remain informed and agile as payer expectations shift, which means the role demands adaptability and proactive coordination. Success often relies on building collaborative relationships and maintaining open channels of communication across departments.

What is the difference between Payer Strategy Manager vs Payer Account Manager?

AspectPayer Strategy ManagerPayer Account Manager
CredentialsBachelor's degree, healthcare or business background, sometimes an MBABachelor's degree, healthcare or business background, often with sales or account management experience
Work EnvironmentStrategic planning, market analysis, cross-functional collaborationClient relationship management, sales, contract negotiations
Employer & Industry UsageHealth insurance companies, pharmaceutical firms, healthcare consultingHealth insurance companies, managed care organizations, pharmaceutical companies

The Payer Strategy Manager focuses on developing and implementing payer strategies through market analysis and cross-functional collaboration. In contrast, the Payer Account Manager primarily manages client relationships, negotiates contracts, and maintains payer accounts. While both roles work within the healthcare payer industry, the Strategy Manager emphasizes planning and market positioning, whereas the Account Manager concentrates on client retention and sales.

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Payer Strategy Manager jobs near you
Infographic showing various Payer Strategy Manager job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 11% Part Time, and 1% Contract. Highlights an 80% Physical, 2% Hybrid, and 18% Remote job distribution, with an average salary of $124,659 per year, or $59.9 per hour.

Healthcare Strategy Manager - VBR & Payer Stategy

Southfield, MI • On-site

EPIC Health System LLC
See more jobs at EPIC Health System LLCexternal

Full-time

Posted 3 days ago

New

Job description

Healthcare Strategy Manager – Value-Based Reimbursement & Payer Strategy

Location: Southfield, MI 
Employment Type: Full-Time 
Reports To: Executive Leadership

Drive Value-Based Healthcare Strategy at EPIC Health

EPIC Health is seeking a strategic and results-driven Healthcare Strategy Manager – Value-Based Reimbursement & Payer Strategy to lead initiatives that improve value-based reimbursement, payer performance, and overall financial and clinical outcomes.

This role will serve as a key partner to executive leadership, Finance, Operations, Clinical Leadership, Revenue Cycle, Credentialing, and external payer and vendor partners. The ideal candidate understands how healthcare reimbursement works beyond traditional fee-for-service and can translate payer contracts, quality metrics, financial data, and operational performance into actionable strategies.

This is a highly collaborative role for someone who can analyze the numbers, negotiate with payers, manage relationships, and drive execution.

What You'll Do

Value-Based Reimbursement Strategy

  • Develop and implement strategies to maximize value-based reimbursement opportunities. 
  • Analyze payer performance, reimbursement models, utilization, quality, and financial results to identify opportunities for improvement. 
  • Monitor performance against value-based contracts and develop action plans to improve results. 
  • Partner with clinical and operational teams to align workflows and initiatives with payer requirements and financial goals.
  • Track key reimbursement and performance metrics and communicate findings to leadership.
  • Support forecasting and financial modeling related to value-based arrangements. 

Payer Relations & Contract Negotiation

  • Build and maintain strong relationships with commercial, Medicare, Medicaid, and other payer partners. 
  • Lead or support payer contract negotiations, renewals, amendments, and performance discussions. 
  • Analyze contract terms, reimbursement rates, incentives, risk arrangements, quality requirements, and other financial provisions. 
  • Identify opportunities to improve reimbursement and strengthen payer relationships. 
  • Serve as a key internal point of contact for payer-related issues and escalations. 
  • Partner with Revenue Cycle and Finance to ensure contractual terms are accurately implemented and monitored.

ACO & Value-Based Program Management

  • Support the strategic management and performance of ACO and other value-based care programs. 
  • Monitor quality, utilization, financial, and patient outcomes associated with value-based contracts. 
  • Partner with clinical and operational leaders to develop initiatives that improve patient outcomes while managing cost and utilization. 
  • Track program requirements, deadlines, deliverables, and performance targets. 
  • Identify performance gaps and coordinate corrective strategies across departments. 

Quality & HEDIS Performance

  • Monitor HEDIS and other payer quality measures that impact reimbursement and value-based performance. 
  • Partner with Quality, Population Health, Clinical Operations, and providers to improve quality measure performance. 
  • Analyze care gaps, utilization trends, and patient populations to identify opportunities for improvement.
  • Support development of initiatives designed to improve HEDIS scores, patient outcomes, and payer incentives. 
  • Stay current on changes to quality measures, payer requirements, and value-based performance methodologies. 

Credentialing & Payer Enrollment

  • Oversee provider credentialing and payer enrollment processes in partnership with internal teams and external vendors. 
  • Manage credentialing and enrollment vendors, ensuring timely completion, accuracy, and accountability. 
  • Monitor provider enrollment status, recredentialing, revalidation, and payer participation. 
  • Ensure new providers are appropriately credentialed and enrolled prior to providing billable services. 
  • Identify and resolve credentialing or enrollment issues that could impact provider participation or reimbursement. 
  • Maintain visibility into credentialing and enrollment timelines, requirements, and outstanding items. 

Data Analysis & Reporting

  • Analyze financial, operational, quality, utilization, and payer performance data. 
  • Develop dashboards, reports, and presentations for executive leadership. 
  • Translate complex data into clear recommendations and actionable strategies. 
  • Monitor trends and identify risks and opportunities across payer contracts and value-based programs. 
  • Support financial forecasting and scenario analysis for new and existing reimbursement arrangements. 

Compliance & Regulatory Strategy

  • Maintain knowledge of federal and state healthcare regulations affecting payer contracts, value-based reimbursement, ACOs, and provider enrollment. 
  • Ensure payer and value-based initiatives are implemented in accordance with applicable regulatory requirements. 
  • Monitor industry and regulatory changes and communicate potential business impacts to leadership.
  • Partner with Compliance, Legal, Finance, and Operations when addressing contractual or regulatory issues. 

Cross-Functional Leadership & Project Management

  • Lead strategic projects involving multiple departments and external partners. 
  • Develop project plans, timelines, milestones, and accountability measures. 
  • Coordinate initiatives across Finance, Operations, Clinical Leadership, Quality, Population Health, Revenue Cycle, Credentialing, and IT. 
  • Identify barriers, manage competing priorities, and drive projects through completion. 
  • Present recommendations and performance updates to executive leadership. 

What You Bring

Required Qualifications

  • Bachelor's degree in Healthcare Administration, Business Administration, Finance, Public Health, ora related field.
  • 5+ years of healthcare experience in value-based reimbursement, payer relations, healthcare strategy, ACO management, managed care, ora related area.
  • Demonstrated experience with payer contract analysis and/or negotiation. 
  • Strong understanding of value-based reimbursement models and healthcare payer operations. 
  • Experience analyzing healthcare financial, quality, and operational data.
  • Experience with 

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