Payer Contracting Manager, Transplant Program

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

📋 Description

• Oversee all facets of designated payer relationships, which includes negotiating and managing contract language, conducting rate and methodology research, resolving disputes, and managing relationships.

• Maintain thorough knowledge of assigned contracts, encompassing language, structure, rates, methodologies, and the providers and facilities involved.

• Ensure that contract language, documentation, negotiations, payment rates, methodologies, storage, and escalated issues align with Payer Contracting standard practices.

• Act as a representative of Payer Contracting and Intermountain Health in significant relationships, including leading Joint Operating Committees.

• Develop and nurture long-term relationships with aligned payers.

• Collaborate with Finance and Revenue Cycle leadership on risk-based contracting, proactive care strategies, and related initiatives.

• Work in conjunction with Legal and Compliance to confirm contract accuracy, regulatory adherence, and consistency of language.

• Offer leadership and guidance to Payer Contracting Managers.

• Travel regularly to negotiate contracts with payers.

⛳️ Requirements

• Proven experience in leading and supporting intricate negotiations.

• Background in a professional capacity that necessitates effective verbal and written communication on advanced topics.

• Competence in synthesizing extensive data into clear and concise summaries without omitting crucial details.

• Experience in leading teams, including cross-functional groups.

• Demonstrated ability in mentoring teams and caregivers.

• Preferred: experience in negotiating complex payer agreements, transplant center-of-excellence arrangements, specialty network contracts, and/or advanced reimbursement models.

• Strong comprehension of case rates, bundled payments, carve-out agreements, and reimbursement for high-acuity services.

• Willingness to travel frequently for contract negotiations with payers.

• Regular use of a computer with the ability to see and read information and documents.

• Capability to meet remote work expectations regarding confidentiality, information security, work schedules, conflicts of interest, and company equipment.

🏝️ Benefits

• Sign-on bonus when applicable.

• Relocation bonus when applicable.

• Eligibility to participate in the Annual Pay for Performance (AP4P) Plan.

• Additional performance compensation opportunity based on the achievement of selected Board-approved goals.

• Comprehensive benefits package that includes wellness, health, security, connection, and engagement programs.

• PEAK up-front tuition coverage paid directly to the academic institution.

• Over 100 learning options available through the PEAK program, including undergraduate studies, high school diplomas, and professional skills and certificates.

• PEAK program eligibility begins on the first day of employment.