The Payer Relations Manager provides all operational oversight and leadership to payer contracting, credentialing, reimbursement support, and communications, ensuring team efficiency, regulatory ...
specialty rx
68 Specialty Rx Payer Relations Manager Jobs Hiring Near You
The Payer Relations Manager provides all operational oversight and leadership to payer contracting, credentialing, reimbursement support, and communications, ensuring team efficiency, regulatory ...
Position Summary The Payer Relations Specialist serves as the subject matter expert for payer ... Knowledge of managed care, PBMs, and payer contracting processes, including specialty therapy ...
Position Summary The Payer Relations Specialist serves as the subject matter expert for payer ... Knowledge of managed care, PBMs, and payer contracting processes, including specialty therapy ...
Specialist Payer Relations
Milwaukee, WI · On-site
Position Summary The Payer Relations Specialist serves as the subject matter expert for payer ... Knowledge of managed care, PBMs, and payer contracting processes, including specialty therapy ...
Specialist Payer Relations
Milwaukee, WI · On-site
Position Summary The Payer Relations Specialist serves as the subject matter expert for payer ... Knowledge of managed care, PBMs, and payer contracting processes, including specialty therapy ...
Specialist Payer Relations
Milwaukee, WI · On-site
The Payer Relations Specialist serves as the subject matter expert for payer engagement and managed ... Knowledge of managed care, PBMs, and payer contracting processes, including specialty therapy ...
Specialist Payer Relations
Milwaukee, WI · On-site
The Payer Relations Specialist serves as the subject matter expert for payer engagement and managed ... Knowledge of managed care, PBMs, and payer contracting processes, including specialty therapy ...
Payer Relations Manager
Elkin, NC · On-site
The Payer Relations Manager provides all operational oversight and leadership to payer contracting, credentialing, reimbursement support, and communications, ensuring team efficiency, regulatory ...
Payer Relations Manager
Elkin, NC · On-site
The Payer Relations Manager provides all operational oversight and leadership to payer contracting, credentialing, reimbursement support, and communications, ensuring team efficiency, regulatory ...
Payer Relations Specialist
Maplewood, NJ · Remote
$20 - $25/hr
Payer Relations Manager Employment: Full-Time, Hourly Location: Maplewood, NJ; Remote Position Company Summary: StationMD is a telehealth company dedicated to serving individuals with intellectual ...
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Payer Relations Specialist
Maplewood, NJ · Remote
$20 - $25/hr
Payer Relations Manager Employment: Full-Time, Hourly Location: Maplewood, NJ; Remote Position Company Summary: StationMD is a telehealth company dedicated to serving individuals with intellectual ...
... Payer Relations Manager to serve as the primary point of contact for Pharmacy Benefit Managers ... Track reimbursement patterns, adjudication behaviors, specialty margins, and PBM performance ...
... Payer Relations Manager to serve as the primary point of contact for Pharmacy Benefit Managers ... Track reimbursement patterns, adjudication behaviors, specialty margins, and PBM performance ...
Payer Relations Manager to serve as the primary point of contact for Pharmacy Benefit Managers ... Track reimbursement patterns, adjudication behaviors, specialty margins, and PBM performance ...
Payer Relations Manager to serve as the primary point of contact for Pharmacy Benefit Managers ... Track reimbursement patterns, adjudication behaviors, specialty margins, and PBM performance ...
The individual will be responsible for the identification, development, and management of strategic relationships with payers and organizations that influence payer decision-making within their ...
The individual will be responsible for the identification, development, and management of strategic relationships with payers and organizations that influence payer decision-making within their ...
Director of Payer Relations
$150K - $220K/yr
Summary:- The Director of Payer Relations is responsible for leading the organization's payer strategy, contract negotiations, and ongoing payer performance management to optimize reimbursement and ...
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Director of Payer Relations
$150K - $220K/yr
Summary:- The Director of Payer Relations is responsible for leading the organization's payer strategy, contract negotiations, and ongoing payer performance management to optimize reimbursement and ...
PAYER RELATIONS SPECIALIST - UWMEDICINE
Seattle, WA · Remote
$90K/yr
Support payer relations operations through research, analysis, and coordination of managed care contracting activities. * Assist with drafting, reviewing, and maintaining contract documents and ...
PAYER RELATIONS SPECIALIST - UWMEDICINE
Seattle, WA · Remote
$90K/yr
Support payer relations operations through research, analysis, and coordination of managed care contracting activities. * Assist with drafting, reviewing, and maintaining contract documents and ...
PAYER RELATIONS SPECIALIST - UWMEDICINE
Seattle, WA · On-site
$90K/yr
Support payer relations operations through research, analysis, and coordination of managed care contracting activities. * Assist with drafting, reviewing, and maintaining contract documents and ...
PAYER RELATIONS SPECIALIST - UWMEDICINE
Seattle, WA · On-site
$90K/yr
Support payer relations operations through research, analysis, and coordination of managed care contracting activities. * Assist with drafting, reviewing, and maintaining contract documents and ...
Collaborate with the Payer Relations & Contracting Manager and legal counsel to address contract-related issues. 3. Payer Relations: Assist in maintaining positive relationships with healthcare ...
Collaborate with the Payer Relations & Contracting Manager and legal counsel to address contract-related issues. 3. Payer Relations: Assist in maintaining positive relationships with healthcare ...
Director of Payer Relations & Contracting Description If you have compassion and the passion for ... This role serves as a key liaison between the company and managed care payers, driving network ...
Quick apply
Director of Payer Relations & Contracting Description If you have compassion and the passion for ... This role serves as a key liaison between the company and managed care payers, driving network ...
Director of Payer Relations & Contracting Description If you have compassion and the passion for ... This role serves as a key liaison between the company and managed care payers, driving network ...
Director of Payer Relations & Contracting Description If you have compassion and the passion for ... This role serves as a key liaison between the company and managed care payers, driving network ...
Payer Relations Director
San Clemente, CA · On-site
The Payer Relations Director (PRD) leads payer strategy within an assigned region to secure and ... Specialty Pharmacy & Pharmacy Benefit Managers * Medical Groups * State Advocacy, patient, provider ...
Payer Relations Director
San Clemente, CA · On-site
The Payer Relations Director (PRD) leads payer strategy within an assigned region to secure and ... Specialty Pharmacy & Pharmacy Benefit Managers * Medical Groups * State Advocacy, patient, provider ...
Payer Relations Director
San Clemente, CA · Remote
The Payer Relations Director (PRD) leads payer strategy within an assigned region to secure and ... Specialty Pharmacy & Pharmacy Benefit Managers * Medical Groups * State Advocacy, patient, provider ...
Payer Relations Director
San Clemente, CA · Remote
The Payer Relations Director (PRD) leads payer strategy within an assigned region to secure and ... Specialty Pharmacy & Pharmacy Benefit Managers * Medical Groups * State Advocacy, patient, provider ...
The Healthcare Payer Relations & Contracting Specialist holds a pivotal role in fostering positive relationships with healthcare payers and managing effective contracts to ensure fair and timely ...
The Healthcare Payer Relations & Contracting Specialist holds a pivotal role in fostering positive relationships with healthcare payers and managing effective contracts to ensure fair and timely ...
Payer Relations Director
San Clemente, CA · Remote
The Payer Relations Director (PRD) leads payer strategy within an assigned region to secure and ... Specialty Pharmacy & Pharmacy Benefit Managers * Medical Groups * State Advocacy, patient, provider ...
Payer Relations Director
San Clemente, CA · Remote
The Payer Relations Director (PRD) leads payer strategy within an assigned region to secure and ... Specialty Pharmacy & Pharmacy Benefit Managers * Medical Groups * State Advocacy, patient, provider ...
AnewHealth is one of the nation's leading pharmacy care management companies that specializes in ... Job Details The Director, Strategic Payer Relations is a leader responsible for managing and ...
AnewHealth is one of the nation's leading pharmacy care management companies that specializes in ... Job Details The Director, Strategic Payer Relations is a leader responsible for managing and ...
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Job description
The Payer Relations Manager provides all operational oversight and leadership to payer contracting, credentialing, reimbursement support, and communications, ensuring team efficiency, regulatory compliance, and alignment with organizational goals. This role collaborates cross-functionally and with internal and external stakeholders to resolve complex issues, improve revenue performance, and strengthen long-term relationships.
Essential Responsibilities and Duties:
- Oversees contract management, credentialing, and payer support functions to ensure accuracy, accountability, and productivity, while directing the execution, documentation, and ongoing maintenance of payer contracts to uphold compliance and support timely renewals in collaboration with leadership.
- Analyzes payer performance data (e.g., denial rates, payment timelines, contract compliance), models payer contracts to forecast financial impacts while leveraging knowledge of claims adjudication and revenue cycle metrics to support strategic decision-making.
- Delegates resolution of payer-related escalations, including claim denials, authorization barriers, payment disputes, and operational bottlenecks, guiding team members and engaging internal and external stakeholders in a timely manner.
- Leads payer credentialing and enrollment processes, ensuring timely submission, tracking, and follow-up of applications in alignment with regulatory standards and payer-specific requirements.
- Demonstrates deep expertise in contracting platforms and systems, overseeing their implementation, optimization, and daily use to ensure accurate contract management, streamlined workflows, and alignment with organizational goals.
- Evaluates payer performance metrics, analyzing trends related to reimbursement, contract compliance, and operational efficiency, and prepares regular performance reports with insights and recommendations for leadership.
- Leads the development and execution of strategic initiatives to build and maintain strong relationships with key insurance payers and industry stakeholders including associations, providers, and advocacy groups, to align contracting efforts with organizational goals, drive referral growth, influence policy, and collaboratively address regulatory and payer-related challenges through active engagement in industry forums and initiatives.
- Drives timely and accurate payer policy changes and operational updates by coordinating cross-functional communication, updating protocols, ensuring staff training, and supporting compliance efforts to maintain seamless care delivery.
- Manages team leaders’ performance by conducting regular reviews, setting clear development goals, and delivering constructive feedback to support individual growth. Identifies training needs and partners with Training & Development to implement professional development programs aligned with team and organizational objectives.
- Promotes a culture of continuous learning and professional development, providing performance feedback, mentoring staff, facilitating team training, and ensuring the team is equipped with the knowledge and tools to meet evolving organizational and payer demands.
- Adheres to company policies and procedures regarding employment, safety, and compliance. Resolve any area of non-compliance immediately.
- Performs other duties as requested by executive leadership/management.
About Prism Medical Products
Sourced by ZipRecruiter
Industry
Personal services
Company size
201 - 500 Employees
Headquarters location
Elkin, NC, US
Year founded
2006