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Payor Relations Jobs in Michigan (NOW HIRING)

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... member relations over the phone and during day-to-day center operations. Duties and ... Appropriately report all critical incidents and safety concerns in accordance with payor ...

... payor-mix and census objectives. * Collects records and analyzes admitting statistics and reports these to required offices. * Facilitates increased community relations with referral sources ...

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Payor Relations information

What is a payor relations?

A Payor Relations job involves managing relationships between healthcare providers and insurance companies (payors) to ensure smooth contract negotiations, reimbursement processes, and compliance with regulations. Professionals in this role work to secure favorable payment terms, resolve disputes, and stay updated on policy changes. They collaborate with internal teams like finance and billing to optimize revenue cycle management and improve patient access to care.

What are some common challenges faced in a payor relations role, and how are they typically managed?

Professionals in Payor Relations often encounter challenges such as navigating complex contract negotiations, resolving claim denials, and staying updated with constantly evolving insurance regulations. Managing these challenges typically involves collaborating closely with internal teams like billing, compliance, and finance, as well as maintaining open communication with representatives from insurance payors. Successful payor relations specialists leverage negotiation skills, industry knowledge, and data analysis to address issues efficiently and advocate for their organization’s interests. Staying proactive and adaptable is key to ensuring smooth operations and maintaining strong partnerships between healthcare providers and payors.

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

To thrive in Payor Relations, you need a strong background in healthcare administration, contract negotiation, and knowledge of reimbursement methodologies, often supported by a bachelor’s degree in business, healthcare, or a related field. Proficiency with claims management systems, contract management software, and familiarity with regulatory compliance tools like HIPAA is typically required. Excellent communication, relationship-building, and problem-solving abilities help foster productive partnerships with insurance payors and internal stakeholders. These skills are vital for ensuring favorable contract terms, resolving disputes efficiently, and supporting the financial goals of healthcare organizations.

What are the most commonly searched types of Payor Relations jobs in Michigan?

The most popular types of Payor Relations jobs in Michigan are:

What are popular job titles related to Payor Relations jobs in Michigan?

For Payor Relations jobs in Michigan, the most frequently searched job titles are:

Infographic showing various Payor Relations job openings in Michigan as of August 2026, with employment types broken down into 100% Full Time. Highlights an 90% In-person, and 10% Remote job distribution.

Licensed Practical Nurse

Progressive Alternatives, Inc.

Kalamazoo, MI • On-site

$23.25 - $31.50/hr

Full-time

Re-posted 26 days ago


Job description

A position providing leadership and assuring quality care, quality nursing care, prudent judgment and providing a safe environment for the Company's clients and employees. Competent nursing involved at all assigned work sites, employees and related duties. Medical knowledge and nursing skills which are outlined in the Charge Nurse Job Description.

Adherence to Company Policies and Procedures, with the ability to meet/exceed the requirements/expectations of referral/payor sources, licensing agencies and clients/family members.RESPONSIBILITIES Serve as an exceptional role model in all areas of leadership, nursing and client care. Oversee Management of assigned sites. Ensure adherence to Policies and Procedures Company wide

Oversee timely completion of employee performance reviews. Meet/exceed county and state licensing and educational requirements. Assist in the recruitment of staff reducing agency use and overtime costs.

Maintain a format for documenting meeting minutes at all assigned sites. Maintain a "Coach vs. Authoritative" leadership style readily accessible to all shifts.

Maintain relationship centered care leadership style. Generate quarterly, semiannual, annual client reports as requested. Assist in generating Plans of Care for clients.

Update as needed. Ensure quality, timely communications with Case Managers, Adjusters, Physicians, Families, etc. Ensure education of staff in direct client care in line with each resident's care plan.

Periodic presence at all PA sites responsible for during all shifts reporting findings and recommendations to Senior Management Team. Mandatory presence and active participation in all Company functions. Weekly communications with PA's Consultant to discuss/resolve management issues.

Marketing. Attend educational and business relation Seminars and Conferences along with required Nursing Continuing Educational Credits. Assist with admissions as needed for all PA sites and home care cases.

Attend to issues that affect overall staff satisfaction. Review and respond accordingly to all incident and accident reports in a timely fashion. Oversee Education, training and supervision of assigned staff to ensure delivery of quality services.

Initiate emergency procedures when necessary. Exercises good judgment in carrying out assigned responsibilities. Available on a rotational basis to share off hours staff calls concerning clients.

Taking disciplinary action as needed, i.e. verbal and written warnings, terminations, (terminations only to be done after consulting CEO and Consultant) Attend Senior Management meetings as scheduled. Review all home reports with Consultant and come up with ways to resolve issues and/or concerns

Explore opportunities for utilization of ex terns at various Progressive Alternatives Sites. Coordinate meetings to be held every other month with Home managers and/or Shift leaders of all sites. Transporting clients to various functions, activities or Physician appointments as needed.

Generate and post House Rules that apply to all consumers in the home and update as needed. Strict adherence to all Kalamazoo Community Mental Health and Recipient Rights Policies and Procedures. Initiate emergency procedures when necessary.

Facilitate changes to management plan as necessary, utilizing disciplinary team approach to modify interventions necessary for client to reach goals. Preparation for yearly site visits. Assist with planning, implementation and coordination of management plans for clients that include goals, objectives, and specific actions to reach stated goals.

Review of medications for clients as needed. Respond to staff questions regarding medical and rehabilitation issues. Ensure compliance with all Company Policies and Procedures.

Administer oral and intravenous medicationsOther duties as assigned including but not limited to: Chart in the medical record Take the patient's vital signs Change wound dressings Collect specimens such as blood, urine, sputum, etc Insert and care for urinary catheters Care for patients with tracheostomy tube and ventilators Insert and care for patients that need nasogastric tubes Give feedings through a nasogastric or gastrostomy tube Care and training of staff with ostomy care Monitor patients for a change in clinical condition Call the physician if needed Perform CPR in emergencies Are supervised by an RNQUALIFICATIONS: Educational/Experiential Graduate. Health-related field. Management and Program development experience in a medical setting.

Experience in carrying out individualized rehabilitation plans.Personal Requirements. Demonstrated leadership and team building skills. Effective Communication skills

Effective conflict resolution experience. Commitment to total quality management/continuous quality improvement. Maintain utmost confidentiality regarding all staff, clients and company business.

Quality nursing skills, knowledge, and good judgment skills in an overall management environment. Other duties as assigned by CEO.Nurse level care with 12 hour daytime shifts. Looking for nurse who has worked with Quadriplegia clients

Experience with TBI preferred. Our client needs a caring and compassionate individual who can prepare meals and assist with set up. Assist with showers and bowel program.

Nurse will need to frequently assess respiratory status due to fragile state. Candidate will need to be able to assess skin frequently, with a knowledge of wound care as well. Client has a supra-pubic catheter that will need to be monitored and changed monthly.

Will need assistance with all Activities of Daily Living. Understand s/s of Autonomic Dysreflexia and be able to respond quickly and appropriately. Must have a valid drivers license.