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Payor Contracting Jobs (NOW HIRING)

Drive the achievement of contracted sales goals and enhance market share and profitability. * Lead the identification, development, negotiation, and management of Payor Relations agreements to ensure ...

Responsible for achieving prioritized contracting targets for market. * Collaborates with director and payor contracting to achieve regional/market goals and contract targets. * Accountable for a ...

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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?

AspectPayor ContractingPayor Credentialing
Required CredentialsExperience in healthcare contracts, negotiation skillsLicenses, certifications, provider credentials
Work EnvironmentContract negotiations, provider agreementsVerification of provider credentials, compliance
Employer & Industry UsageHealth insurance companies, provider networksHospitals, clinics, insurance payers
Search & Comparison IntentUnderstanding contract processes, negotiationsVerifying 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.

More about Payor Contracting jobs

What cities are hiring for Payor Contracting jobs?

Cities with the most Payor Contracting job openings:

What states have the most Payor Contracting jobs?

States with the most job openings for Payor Contracting jobs include:

Infographic showing various Payor Contracting job openings in the United States as of August 2026, with employment types broken down into 92% Full Time, 3% Part Time, and 5% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution.

Credentialing and Payor Contracting Specialist (Full-Time)

ChildServe

Johnston, IA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.


ChildServe rating

7.2

Company rating: 7.2 out of 10

Based on 20 frontline employees who took The Breakroom Quiz


Job description

This is a newly created role responsible for overseeing end-to-end provider and entity credentialing, payor enrollment, and medical staff privileging to ensure timely and accurate participation with Medicaid, MCOs, and commercial payors. The position also supports payor contracting by coordinating contract processes and assisting with financial and reimbursement analysis in partnership with key internal teams.

How You'll Have an Impact

Payor Credentialing & Enrollment

  • Manage end-to-end credentialing and enrollment of organizational entities with Medicaid, MCOs, and commercial payors.
  • Credential and recredential physicians, advanced practice providers (APPs), and other clinical providers with all applicable payors.
  • Maintain credentialing timelines to avoid lapses in participation or reimbursement.
  • Serve as the primary point of contact with payors for credentialing-related inquiries, follow-ups, and issue resolution.
  • Maintain accurate provider and entity data in credentialing systems, CAQH, and internal databases.

Hospital Medical Staff Privileging

  • Provide administrative support for hospital medical staff credentialing and privileging processes.
  • Compile, submit, and track required documentation for initial and ongoing privileges.
  • Monitor expiration dates and renewal cycles to ensure continuous compliance with hospital and regulatory requirements.
  • Coordinate communication between providers, hospitals, and internal stakeholders related to privileging status.

Payor Contract Financial Analysis Support

  • Assist with the financial review and analysis of payor contracts in coordination with the Director of Revenue Cycle and the VP of Government Relations.
  • Support evaluation of reimbursement methodologies, rate structures, and contract terms.
  • Help prepare summaries, comparisons, and impact analyses to inform contract negotiations and strategic decision-making.
  • Maintain organized records of executed payor agreements and supporting financial documentation.

Contract Intake, Review & Dissemination

  • Serve as the central point person for coordinating the intake, tracking, and dissemination of all organizational contracts (payor and non-payor).
  • Manage and enforce the contract checklist process for contracts entering or exiting the organization, ensuring appropriate review and approvals.
  • Coordinate with legal, finance, compliance, operations, and executive leadership to ensure contracts move efficiently through the review process.
  • Maintain a centralized contract repository with accurate status tracking, key dates, and version control.
  • Support contract renewals, amendments, and terminations by monitoring deadlines and notifying stakeholders.


What You'll Need

  • Bachelor's degree in Accounting, Finance, Economics, or Healthcare Administration with a strong accounting or financial analysis foundation.
  • 2+ years of experience in a financial analyst, contracting analyst, revenue cycle, or healthcare finance-adjacent role with demonstrable analytical responsibility. Experience in public accounting, internal audit, FP&A, revenue integrity, or healthcare finance.
  • Ability to understand and communicate effectively and professionally in reading, writing, and speaking the English language.

Benefits

  • Medical, dental, and vision insurance
  • Health Savings Account (HSA) and Flexible Spending Account (FSA) options
  • Employee Assistance Program (EAP)
  • 403(b) retirement plan with company match
  • Life and disability insurance
  • Paid Time Off (PTO)

Make a Difference Every Day at ChildServe

  • ChildServepartners with families to help children with special healthcare needs live agreatlife.
  • ChildServeis a leading pediatric healthcare provider with Iowa's only children's specialty hospital, offering a variety of services and programs to meet each child's unique needs.
  • ChildServe'sfour key specialty areas include: complex medical care, pediatric rehabilitation, autism and behavioral health, and community-based services. With a coordinated approach to care delivery, services are interwoven and streamlined, so families can address their child's needs in one location.
  • Established in 1928, ChildServeproudly provides more than 30 pediatric specialty services to nearly 6,000 children in Iowa each year.

ChildServeis committed to working with and providing reasonableaccommodationsto applicants with disabilities. To request assistance with the application process, please emailcareers@childserve.org. ChildServeis an Equal Opportunity Employer.

Employment Type: Full-Time

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