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Payer Strategy Manager Jobs in Georgia (NOW HIRING)

ApolloMD

Payer Dispute Analyst (57547)

Atlanta, GA

Manage designated aspects of the No Surprises Act IDR and state dispute resolution processes, from ... Collaborate with legal, revenue cycle, and clinical teams to support dispute strategies and ...

SGA Dental Partners

Insurance Contract Specialist

Claxton, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Support the development and execution of payer strategies to optimize reimbursement and improve ... Monitor and manage payer contracts and fee schedules, identifying discrepancies and supporting ...

SGA Dental Partners

Insurance Contract Specialist

Claxton, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Support the development and execution of payer strategies to optimize reimbursement and improve ... Monitor and manage payer contracts and fee schedules, identifying discrepancies and supporting ...

KPMG

Director, Payer Innovation and Alliances

Atlanta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Help to develop, sell and deliver technology enabled healthcare strategy and transformation service ... Drive team performance and quality delivery through appropriate project management, project budget ...

KPMG

Director, Payer Innovation and Alliances

Atlanta, GA

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Help to develop, sell and deliver technology enabled healthcare strategy and transformation service ... Drive team performance and quality delivery through appropriate project management, project budget ...

Pfizer

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

The Access Care Manager (ACM) serves as a field-based access leader responsible for integrating ... Internal Strategic Influence & Market Insights * Provide actionable insights on payer trends ...

City of Atlanta

Debt Manager

Atlanta, GA · On-site

$73K - $97K/yr

... paying agent, financial advisor, trustees, rating agencies, bond counsel, and any other pertinent ... Manage the portfolio prioritizing issuances in accordance with strategic priorities identified ...

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Payer Strategy Manager information

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.

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 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 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 are the most commonly searched types of Payer Strategy jobs in Georgia?

The most popular types of Payer Strategy jobs in Georgia are:

What are popular job titles related to Payer Strategy Manager jobs in Georgia?

For Payer Strategy Manager jobs in Georgia, the most frequently searched job titles are:

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The top searched job categories for Payer Strategy Manager jobs in Georgia are:

What cities in Georgia are hiring for Payer Strategy Manager jobs?

Cities in Georgia with the most Payer Strategy Manager job openings:

Payer Strategy Manager jobs near you

Payer Dispute Analyst (57547)

ApolloMD

Atlanta, GA

Full-time

Posted 6 days ago

Job description

About ApolloMD

ApolloMD partners with more than 100 hospitals nationwide to provide integrated, multispecialty physician, APC and practice management services in Emergency Medicine, Hospital Medicine, Anesthesia, and Revenue Cycle Management. Our high touch, solution-based approach emphasizes quality, efficiency, communication and patient experience. ApolloMD works collaboratively with partner facilities to implement best practices and process improvement across the board in a cost-effective manner. Learn more about our growing team at apollomd.com.

Position Summary
The Payer Dispute Analyst supports the organization's efforts to resolve disputes with payers. This role focuses heavily on the Independent Dispute Resolution (IDR) process under the No Surprises Act and state dispute resolution processes, while maintaining flexibility to handle additional payer dispute matters and processes as needed. The Analyst will review and analyze claims for reimbursement and work collaboratively with internal teams and external entities to secure appropriate reimbursement.

Key Responsibilities

  •  Review, analyze, and interpret claims data to ensure accurate payment in alignment with applicable policies and regulatory requirements.
  • Research and prepare reports identifying trends, recurring issues, and high-level reimbursement concerns.
  • Manage designated aspects of the No Surprises Act IDR and state dispute resolution processes, from case initiation through final payer determination.
  • Prepare and submit Final Offers through the CMS portal, ensuring accuracy and strict adherence to regulatory deadlines.
  • Oversee the resolution process for claims in dispute, including documentation, submission, and follow-up to ensure proper reimbursement.
  • Compile and organize supporting materials including Position Statements (Briefs), Good Faith Negotiation documents, and relevant clinical documentation.
  • Track submission timelines and proactively manage deadlines to ensure timely case processing.
  • Maintain comprehensive, audit-ready records of all dispute submissions and outcomes.
  • Collaborate with legal, revenue cycle, and clinical teams to support dispute strategies and documentation needs.
  • Maintain up-to-date knowledge of payer policies, state/federal regulations, and industry best practices related to dispute resolution.
  • Assist in developing process improvements to enhance efficiency, accuracy, and compliance.
  • Support special projects and other duties as assigned to meet departmental and organizational objectives.

Qualifications
Required

  • 2+ years of experience in healthcare claims, payer disputes, or revenue cycle.
  • Strong organizational skills with the ability to manage multiple priorities in a high-volume, fast-paced environment.
  • Excellent verbal and written communication skills.
  • Proactive, team-oriented mindset with a high degree of professionalism.
  • Strong problem-solving and analytical abilities.
  • Proficiency in Microsoft Excel and other Microsoft Office applications.
  • High School Diploma or equivalent required; Bachelor's degree preferred.

Preferred

  • Working knowledge of the No Surprises Act and federal IDR processes.
  • Experience with accounts receivable, payer disputes, or legal disputes.
  • Familiarity with the Athena billing system.
  • Experience with state dispute resolution processes or similar payer dispute workflows.
  • Background in medical billing, claims processing, or payer-provider dispute resolution.

Core Competencies

  • Exceptional attention to detail and organizational discipline.
  •  Ability to manage competing priorities and strict regulatory deadlines.
  • Genuine interest in healthcare policy, revenue cycle, or compliance.
  • Strong cross-functional collaboration and communication skills.
  • Analytical mindset with the ability to review and interpret complex claims data.
     

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