Manager

• Oversees payer relationships, Joint Operating Committees, operational and utilization management meetings, and facilitates communication with payers.
• Manage and coordinate functions and/or resources associated with organizing, implementing and meeting goals/guidelines.
• Engage and manage escalations of payer issues.
• Participate in development and oversight of payer performance reporting and scorecards.
• Coordinate and manage relevant payer meetings to facilitate relationships and resolution of issues.
• Research and escalate emerging payer issues and drive problem resolution.
• Act as a liaison to resolve complex issues and payment challenges.
• Stay current on payer policies, regulatory changes, and reimbursement trends, and identify concerns for escalation process.
• Develop scorecards and reports to monitor payer performance.
• Participate with leadership teams to provide clarity to the scope of work.
• Communicate status of operations to management and associates.
• Develop presentation materials various levels of management discussions and payer meetings.
• Prepare and analyze departmental financial reports, financial analysis and budgetary reports.

Manager, Payer Relations

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About the role

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Hard skills

Soft skills