Manager, Payor Relations – Southern Region

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Oversee payer contracting and network development strategies throughout southern states, encompassing Medicaid, Medicare, Commercial, IPAs, and TPAs.

• Lead and nurture a high-performing team of three contracting specialists.

• Establish and sustain relationships with health plans.

• Direct negotiations, policy escalations, and network development efforts.

• Propel payer network expansion, advocate for payer policy changes, and negotiate fee schedules.

• Ensure that payer contract data is meticulously updated and configured within internal systems.

• Collaborate effectively with Legal, Compliance, Revenue Cycle, Sales, and Operations teams.

• Lead and participate in cross-functional projects involving multiple stakeholders.

• Manage priorities through clear and effective communication.

• Audit internal processes and mentor team members to ensure compliance, alignment, and ongoing improvement.

• Guide and support the team in payer expansion, policy modifications, contract negotiations, and configurations.

• Lead or engage in company-wide payer strategy initiatives.

• Refine processes and develop the team to guarantee accuracy, clarity, and effectiveness.

• Uphold HIPAA regulations and maintain patient confidentiality.

⛳️ Requirements

• Minimum of 5 years in healthcare operations, network development, or managed care contracting.

• Experience with providers, hospitals, or DME is preferred.

• Demonstrated experience in negotiating contracts with health plans or providers.

• Proven track record in managing and developing teams, particularly those new to the industry or function.

• Familiarity with Medicaid, Medicare, Commercial, IPAs, and TPAs.

• Strong understanding of claims workflows and relationships between payers and providers.

• Capability to manage escalations, coach team members, and implement scalable processes.

• Preference for candidates located within one hour of a major airport, particularly in the Northeast region.

• Experience in managing cross-functional projects and reporting to various stakeholders or leaders is preferred.

• Familiarity with fee schedule configuration and payer system setup is preferred.

• Knowledge of payer compliance and policy monitoring is preferred.

• Must adhere to HIPAA and patient confidentiality requirements.

• Understanding and compliance with applicable laws, regulations, and policies are essential.

• Willingness to travel quarterly to Aeroflow’s corporate office.

• Commitment to equal opportunity and adherence to workplace policies.

🏝️ Benefits

• Health Plans with FSA or HSA options.

• Dental insurance.

• Vision insurance.

• Optional Life Insurance.

• 401K with Company Match.

• 12 weeks of parental leave for birthing parents.

• 4 weeks of leave for non-birthing parent(s).

• Fertility stipends.

• Free diapers.

• Breast pump.

• Paid Holidays.

• PTO Accrual from day one.

• Employee Assistance Programs.

• Competitive Pay.