The role leads payor enrollment processes on behalf of facility leadership to ensure readiness for contracting in both new and existing markets. In addition, this position supports KTS Account ...
The role leads payor enrollment processes on behalf of facility leadership to ensure readiness for contracting in both new and existing markets. In addition, this position supports KTS Account ...
Develops and executes payer negotiation and contracting strategies for assigned ambulatory surgery ... Understanding of healthcare industry trends in payor negotiations including contract language ...
Develops and executes payer negotiation and contracting strategies for assigned ambulatory surgery ... Understanding of healthcare industry trends in payor negotiations including contract language ...
Manager of Managed Care Operations - Hybrid / Remote
Brentwood, TN · On-site +1
$84K - $112K/yr
Develops and executes payer negotiation and contracting strategies for assigned ambulatory surgery ... Understanding of healthcare industry trends in payor negotiations including contract language ...
Manager of Managed Care Operations - Hybrid / Remote
Brentwood, TN · On-site +1
$84K - $112K/yr
Develops and executes payer negotiation and contracting strategies for assigned ambulatory surgery ... Understanding of healthcare industry trends in payor negotiations including contract language ...
Payor Mix: Contracted with "all" payors except Cigna. 55% BCBS * Base/Income:200K * Production/Bonus Info: Yes Production and Customer Satisfaction * Buy-in or partnership? No * CME allowance: We pay ...
Payor Mix: Contracted with "all" payors except Cigna. 55% BCBS * Base/Income:200K * Production/Bonus Info: Yes Production and Customer Satisfaction * Buy-in or partnership? No * CME allowance: We pay ...
Payor Mix: Contracted with "all" payors except Cigna. 55% BCBS * Base/Income:200K * Production/Bonus Info: Yes Production and Customer Satisfaction * Buy-in or partnership? No * CME allowance: We pay ...
Payor Mix: Contracted with "all" payors except Cigna. 55% BCBS * Base/Income:200K * Production/Bonus Info: Yes Production and Customer Satisfaction * Buy-in or partnership? No * CME allowance: We pay ...
Project Manager, Provider Network Contract Validation
Franklin, TN · On-site
$60K - $159K/yr
... Payor) - Project Management - Basic understanding of Provider Contracting - Experience with EXCEL and working with large data files is critical. Preferred Qualifications - Claims processing ...
Posted today
Project Manager, Provider Network Contract Validation
Franklin, TN · On-site
$60K - $159K/yr
... Payor) - Project Management - Basic understanding of Provider Contracting - Experience with EXCEL and working with large data files is critical. Preferred Qualifications - Claims processing ...
Posted today
... and contracting process * Experience working with payor networks throughout the country including government health programs as well as commercial insurance networks * Excellent telephone ...
... and contracting process * Experience working with payor networks throughout the country including government health programs as well as commercial insurance networks * Excellent telephone ...
CVO Specialist - Provider Enrollment Coordinator
Nashville, TN · On-site
$36K - $45K/yr
... and contracting process * Experience working with payor networks throughout the country including government health programs as well as commercial insurance networks * Excellent telephone ...
CVO Specialist - Provider Enrollment Coordinator
Nashville, TN · On-site
$36K - $45K/yr
... and contracting process * Experience working with payor networks throughout the country including government health programs as well as commercial insurance networks * Excellent telephone ...
Senior Counsel
Nashville, TN · On-site
$132K - $179K/yr
Draft, review, and negotiate doctor employment agreements, vendor agreements, payor agreements ... Develop templates, contracting procedures, and practical guidance for recurring operational legal ...
Quick apply
Senior Counsel
Nashville, TN · On-site
$132K - $179K/yr
Draft, review, and negotiate doctor employment agreements, vendor agreements, payor agreements ... Develop templates, contracting procedures, and practical guidance for recurring operational legal ...
Senior Counsel
Nashville, TN · On-site
$132K - $179K/yr
Draft, review, and negotiate doctor employment agreements, vendor agreements, payor agreements ... Develop templates, contracting procedures, and practical guidance for recurring operational legal ...
Senior Counsel
Nashville, TN · On-site
$132K - $179K/yr
Draft, review, and negotiate doctor employment agreements, vendor agreements, payor agreements ... Develop templates, contracting procedures, and practical guidance for recurring operational legal ...
Senior Counsel
$132K - $179K/yr
Draft, review, and negotiate doctor employment agreements, vendor agreements, payor agreements ... Develop templates, contracting procedures, and practical guidance for recurring operational legal ...
Senior Counsel
$132K - $179K/yr
Draft, review, and negotiate doctor employment agreements, vendor agreements, payor agreements ... Develop templates, contracting procedures, and practical guidance for recurring operational legal ...
... contracting systems, and productivity platforms. * Lead ERP strategy, implementation, and ... payor, and vendor relationships. * Lead HRIS and workforce platform strategy, ensuring systems ...
... contracting systems, and productivity platforms. * Lead ERP strategy, implementation, and ... payor, and vendor relationships. * Lead HRIS and workforce platform strategy, ensuring systems ...
Payer Enrollment Specialist
Franklin, TN · On-site
... and payor enrollment processes for Fast Pace. The Payer Enrollment Specialist will play an ... Initiate payer contracting requests and collaborate with contracting to facilitate network ...
Payer Enrollment Specialist
Franklin, TN · On-site
... and payor enrollment processes for Fast Pace. The Payer Enrollment Specialist will play an ... Initiate payer contracting requests and collaborate with contracting to facilitate network ...
Payer Enrollment Specialist
Franklin, TN · On-site
... and payor enrollment processes for Fast Pace. The Payer Enrollment Specialist will play an ... Initiate payer contracting requests and collaborate with contracting to facilitate network ...
Payer Enrollment Specialist
Franklin, TN · On-site
... and payor enrollment processes for Fast Pace. The Payer Enrollment Specialist will play an ... Initiate payer contracting requests and collaborate with contracting to facilitate network ...
Payer Enrollment Specialist
Franklin, TN · On-site
... and payor enrollment processes for Fast Pace. The Payer Enrollment Specialist will play an ... Initiate payer contracting requests and collaborate with contracting to facilitate network ...
Payer Enrollment Specialist
Franklin, TN · On-site
... and payor enrollment processes for Fast Pace. The Payer Enrollment Specialist will play an ... Initiate payer contracting requests and collaborate with contracting to facilitate network ...
Position serves both internal co-workers and external customers, clients, patients, contractors ... Have an active role and shared governance in payor enrollment process. * Operational Efficiency:
Position serves both internal co-workers and external customers, clients, patients, contractors ... Have an active role and shared governance in payor enrollment process. * Operational Efficiency:
Division Chief Financial Officer- Acute Care
Brentwood, TN · On-site
$180 - $270/hr
Position serves both internal co-workers and external customers, clients, patients, contractors ... Have an active role and shared governance in payor enrollment process. * Operational Efficiency:
Division Chief Financial Officer- Acute Care
Brentwood, TN · On-site
$180 - $270/hr
Position serves both internal co-workers and external customers, clients, patients, contractors ... Have an active role and shared governance in payor enrollment process. * Operational Efficiency:
Prepare and participate in payor audits for assigned clients, offering support in areas such as ... Act as a liaison between internal payer contracting and operational teams to resolve credentialing ...
Prepare and participate in payor audits for assigned clients, offering support in areas such as ... Act as a liaison between internal payer contracting and operational teams to resolve credentialing ...
Division Chief Financial Officer
Brentwood, TN · On-site
$200 - $260/hr
Position serves both internal co-workers and external customers, clients, patients, contractors ... Have an active role and shared governance in payor enrollment process. * Operational Efficiency:
Division Chief Financial Officer
Brentwood, TN · On-site
$200 - $260/hr
Position serves both internal co-workers and external customers, clients, patients, contractors ... Have an active role and shared governance in payor enrollment process. * Operational Efficiency:
Position serves both internal co-workers and external customers, clients, patients, contractors ... Have an active role and shared governance in payor enrollment process. * Operational Efficiency:
Position serves both internal co-workers and external customers, clients, patients, contractors ... Have an active role and shared governance in payor enrollment process. * Operational Efficiency:
Payor Contracting information
What is payor contracting?
Payor Contracting refers to the process in healthcare where providers, such as hospitals or physician groups, negotiate agreements with insurance companies or government programs (the payors) regarding reimbursement terms for healthcare services. These contracts specify rates, covered services, payment schedules, and other important terms. Effective payor contracting ensures that healthcare organizations receive fair compensation for the care they provide and helps patients access care through their insurance plans.
What are the key skills and qualifications needed to thrive in payor contracting?
To excel in Payor Contracting, you need strong analytical skills, knowledge of healthcare reimbursement, and experience with contract negotiation, usually supported by a degree in healthcare administration, business, or a related field. Familiarity with contract management systems, claims processing software, and regulatory compliance tools is typical. Excellent communication, attention to detail, and relationship-building abilities are crucial soft skills for this role. These competencies ensure effective negotiation, compliance, and mutually beneficial agreements between healthcare providers and payors.
What are some common challenges faced by professionals in payor contracting, and how can they be addressed?
Professionals in Payor Contracting often encounter challenges such as negotiating favorable reimbursement rates, navigating complex regulatory requirements, and managing multiple contract renewals simultaneously. These can be addressed by staying informed about industry trends, fostering strong relationships with payors, and maintaining meticulous contract documentation. Collaboration with legal, compliance, and finance teams is crucial to ensure all agreements align with organizational goals and regulatory standards, ultimately leading to more successful contract outcomes.
What is the difference between Payor Contracting vs Payor Credentialing?
| Aspect | Payor Contracting | Payor Credentialing |
|---|---|---|
| Required Credentials | Experience in healthcare contracts, negotiation skills | Licenses, certifications, provider credentials |
| Work Environment | Contract negotiations, provider agreements | Verification of provider credentials, compliance |
| Employer & Industry Usage | Health insurance companies, provider networks | Hospitals, clinics, insurance payers |
| Search & Comparison Intent | Understanding contract processes, negotiations | Verifying provider credentials, compliance standards |
Payor Contracting focuses on negotiating and establishing provider agreements with insurance payers, requiring negotiation skills and contract knowledge. Payor Credentialing involves verifying provider credentials and ensuring compliance, emphasizing licensing and certification verification. Both roles are essential in healthcare administration but serve different functions within the payer-provider relationship.
What are popular job titles related to Payor Contracting jobs in Tennessee?
For Payor Contracting jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Payor Contracting jobs in Tennessee look for?
The top searched job categories for Payor Contracting jobs in Tennessee are:
- Vice President Remote Medical Staff Credentialing
- Good Paying Government
- Manager Health Insurance Enrollment
- Remote International Plastic Surgery Physician
- Eft Era Enrollment
- Remote Macular Degeneration
- Commission Medicare Provider Enrollment Analyst
- Healthcare Contracting
- Remote Brain Training
- Remote Credentialing Verification Organization
What cities in Tennessee are hiring for Payor Contracting jobs?
Cities in Tennessee with the most Payor Contracting job openings:
Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 14 days ago
Universal Health Services rating
6.9
Based on 254 frontline employees who took The Breakroom Quiz
455th of 898 rated healthcare providers
Job description
Responsibilities
Kidlink Treatment Services (a UHS company) Kidlink Treatment Services' network of programs includes more than 50 specialized educational and residential behavioral treatment centers. Each center provides programming for children and adolescents who may have been unsuccessful in previous treatment settings. These services provide access to programs for male and female youth, including those with low cognitive functioning, severe emotional disturbance, sexually abusive behaviors, psychiatric disorders, or extreme anger or aggression issues. For more information please visithttps://kidlinknetwork.com
Position Summary: This position is responsible for evaluating new and existing business opportunities to determine financial and operational viability, while developing and maintaining a comprehensive funding playbook for each stream. The role leads payor enrollment processes on behalf of facility leadership to ensure readiness for contracting in both new and existing markets. In addition, this position supports KTS Account Managers, facility leadership, and the NRO Central Billing Office by overseeing contract and SCA execution, managing renewals and rate increases, tracking funding trends, and driving solutions for accounts receivable challenges tied to patient placements in KTS-supported programs.
Success in this role requires strong insight into payors and the reimbursement landscape, along with the ability to navigate new business opportunities. The individual must build effective partnerships with payors, facility leadership, and corporate teams, while managing multiple projects under tight deadlines. A commitment to customer service and excellent communication skills are essential.
Essential Job Duties Responsibilities:
About Universal Health Services
Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation's largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. www.uhs.com .
Qualifications
Requirements and Specialized Skills :
20% Local/Regional
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Avoid and Report Recruitment Scams
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS
and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
Kidlink Treatment Services (a UHS company) Kidlink Treatment Services' network of programs includes more than 50 specialized educational and residential behavioral treatment centers. Each center provides programming for children and adolescents who may have been unsuccessful in previous treatment settings. These services provide access to programs for male and female youth, including those with low cognitive functioning, severe emotional disturbance, sexually abusive behaviors, psychiatric disorders, or extreme anger or aggression issues. For more information please visithttps://kidlinknetwork.com
Position Summary: This position is responsible for evaluating new and existing business opportunities to determine financial and operational viability, while developing and maintaining a comprehensive funding playbook for each stream. The role leads payor enrollment processes on behalf of facility leadership to ensure readiness for contracting in both new and existing markets. In addition, this position supports KTS Account Managers, facility leadership, and the NRO Central Billing Office by overseeing contract and SCA execution, managing renewals and rate increases, tracking funding trends, and driving solutions for accounts receivable challenges tied to patient placements in KTS-supported programs.
Success in this role requires strong insight into payors and the reimbursement landscape, along with the ability to navigate new business opportunities. The individual must build effective partnerships with payors, facility leadership, and corporate teams, while managing multiple projects under tight deadlines. A commitment to customer service and excellent communication skills are essential.
Essential Job Duties Responsibilities:
- Evaluates new and existing business opportunities to determine financial and operational viability.
- Develops funding playbook for each funding stream, updates as necessary.
- Leads and executes payor enrollment processes for facility leadership, to endure readiness for contracting in new and existing markets.
- Develops and delivers training to facility teams on end-to-end payor processes for KTS generated business, including contract implementation, prior authorization workflows and billing protocols.
- Assists facility leadership in negotiating competitive reimbursement rates consistent with division standard.
- Challenging and rewarding work environment
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- SoFi Student Loan Refinancing Program
- Career development opportunities within UHS and its 300+ Subsidiaries!
About Universal Health Services
Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation's largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. www.uhs.com .
Qualifications
Requirements and Specialized Skills :
- Bachelor's Degree required
- 5-8 years related experience required, 8-10 preferred
- Strategic insight into major payors and the reimbursement landscape.
- Ability to handle multiple projects under strict deadlines while remaining flexible to changing priorities.
- Ability to identify and navigate reimbursement for new business.
- Demonstrates a commitment to exceptional customer service.
- Exceptional interpersonal skills, fostering productive partnerships among payors, facility leadership and corporate teams.
- Excellent oral and written communication skills.
20% Local/Regional
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Avoid and Report Recruitment Scams
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS
and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
What Universal Health Services employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Universal Health Services
Sourced by ZipRecruiter
Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
King of Prussia, PA, US