Payer Strategy Manager
Ivy Rehab Network
full-time
Posted on:
Location Type: Hybrid
Location: Nashville • Florida • Tennessee • United States
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About the role
- Create, set agendas for, and lead Joint Operating Committee (JOC) calls with payors to resolve systemic issues.
- Lead managed care contract negotiations, with a primary focus on government payors.
- Act as the final point of escalation for complex claims, credentialing disputes, and high-level third-party vendor issues.
- Ensure the organization maintains current fee schedules and stays updated on timely filing and claim form requirements.
- Partner with the RCM team to identify and fix systemic causes for incorrect payments, authorization hurdles, and credentialing gaps.
- Collaborate with all parties to develop denial prevention methods and oversee the follow-up on Accounts Receivable to ensure claims are processed or appealed.
- Actively engage in the research, setup, and testing of new payor information within EMR systems.
- In partnership with teammates, analyze data sets to perform payor contract modeling and evaluate the financial viability of existing and new agreements.
- Own the delivery of updates for the Monthly Operational Review (MOR) and provide field leadership with actionable performance reporting.
- Identify and resolve complex reimbursement issues through targeted data-driven analysis and rate reviews.
- Assist Patient Coordinators (PCs) and patients with billing inquiries; work cross-functionally to resolve user issues across all departments.
- Maintain professional, direct communication with payors via phone and email to facilitate rapid problem-solving.
Requirements
- High School Diploma or GED required; Bachelor’s degree in Healthcare Administration or related field preferred.
- 3–5 years of experience in healthcare RCM, managed care, or payor relations.
- Advanced skills in Microsoft Office Suite (Excel, Word, Outlook, and Access).
- Proven ability to analyze complex data sets and develop financial tools for leadership.
- Exceptional oral and written communication skills; comfortable leading professional calls with external stakeholders and presenting to executive leadership.
- A high sense of urgency, the ability to prioritize tasks in a fast-paced environment, and a commitment to quality customer service.
Benefits
- Generous PTO (Paid Time Off) plans and paid holidays.
- Hybrid and remote work flexibility.
- Eligibility for full benefits package beginning within your first month of employment.
- Empowering Values: Live by values that prioritize teamwork, growth, and serving others.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analysisfinancial modelingclaims processingcontract negotiationreimbursement analysiscredentialingdenial preventionfee schedule maintenancepayor relationsbilling inquiries
Soft Skills
communicationleadershipproblem-solvingcollaborationtime managementcustomer serviceanalytical thinkingprioritizationinterpersonal skillsurgency
Certifications
High School DiplomaGEDBachelor’s degree in Healthcare Administration