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77 Specialty Rx Payer Relations Manager Jobs Hiring Near You

NY · On-site

$180 - $300/hr

Contract Negotiation and Management * Lead negotiations for commercial, Medicare Advantage, managed ... specialty care. * Maintain a centralized process for monitoring contract terms, renewal dates ...

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 ...

VP of Payer Relations

Roseville, MN · On-site

$180K - $210K/yr

Position Overview The Vice President of Payer Relations is a senior executive responsible for ... Payer Relationship Management * Serve as the executive point of contact for national, regional, and ...

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Vice President, Payer Relations & Contracting

IVX Health

Brentwood, TN

Full-time

Posted 25 days ago


IVX Health rating

5.8

Company rating: 5.8 out of 10

Based on 7 frontline employees who took The Breakroom Quiz


Job description

Employment Type: Full Time, W-2
 
The Vice President, Payer Relations & Contracting leads IVX Health's national payer strategy, contracting, reimbursement optimization, and health plan partnerships. This executive will drive network expansion, negotiate payer agreements, improve reimbursement performance, and strengthen relationships with national and regional health plans.
 
As a member of the Growth Leadership Team, this leader partners across Operations, Revenue Cycle, Finance, Legal, and Market Development to expand patient access, improve financial performance, and support enterprise growth.
 

Key ResponsibilitiesPayer Strategy & Contracting
  • Lead IVX's national payer contracting and network access strategy.
  • Negotiate and manage agreements with commercial, Medicare Advantage, Medicaid, and regional health plans.
  • Expand payer participation, improve reimbursement economics, and support new market growth.
  • Build executive relationships with key payer organizations and position IVX as a preferred site-of-care partner.
Reimbursement & Performance
  • Own enterprise reimbursement strategy and contract performance.
  • Identify opportunities to improve reimbursement, prevent underpayments, and strengthen contract compliance.
  • Monitor payer policy, medical necessity, and reimbursement trends affecting patient access and revenue.
  • Partner with Revenue Cycle, Finance, Operations, and Legal to address reimbursement risks and opportunities.
Strategic Partnerships
  • Serve as IVX's executive liaison to payer organizations.
  • Lead payer business reviews and strategic planning discussions.
  • Support select employer, TPA, and alternative reimbursement partnerships.
  • Identify opportunities to expand payer collaboration and value creation.
Leadership & Collaboration
  • Align payer strategy across Growth, Operations, Clinical, Revenue Cycle, Finance, Legal, and Analytics teams.
  • Translate contractual commitments into operational execution.
  • Lead and develop the payer strategy function.
  • Establish KPIs tied to network growth, reimbursement performance, and enterprise objectives.

QualificationsRequired
  • 10+ years of healthcare leadership experience in payer relations, managed care contracting, reimbursement strategy, or network development.
  • Bachelor's degree required.
  • Proven success negotiating payer contracts and expanding network access.
  • Experience supporting ambulatory, infusion, specialty, or alternative site-of-care healthcare organizations.
  • Deep knowledge of managed care, reimbursement, specialty drug economics, payer operations, and medical policy.
  • Strong executive communication, relationship-building, and financial acumen.
Preferred
  • Experience in infusion services, specialty pharmacy, ambulatory care, or provider organizations.
  • Established relationships with major national payers including UnitedHealthcare, Cigna, Aetna, Elevance, BCBS plans, and Humana.

Success Measures
  • Expanded payer access and covered lives.
  • Improved reimbursement rates and contract performance.
  • Successful payer negotiations and renewals.
  • Strong executive payer relationships.
  • Margin improvement and reimbursement optimization.
  • Achievement of growth and financial goals.

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