Director of Payer Relations – Contracting
Quipt Home Medical
full-time
Posted on:
Location Type: Remote
Location: United States
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Job Level
About the role
- Develop and execute national and regional strategies to expand payer contracts and optimize network participation.
- Negotiate favorable contract terms, reimbursement rates, and value-based arrangements with commercial and government payers.
- Evaluate new network opportunities and maintain optimal in-network positioning.
- Analyze payer contracts to assess financial performance, reimbursement structures, and compliance requirements.
- Identify opportunities to improve margins, reduce administrative burden, and enhance contract terms.
- Partner with finance and operations teams to model contract performance and support strategic decision-making.
- Track and monitor all contract activity across assigned markets.
- Build and maintain strong relationships with payer executives and network management teams.
- Serve as the primary liaison between the organization and payer partners.
- Lead payer meetings, presentations, and high-level negotiations.
- Collaborate with revenue cycle management (RCM), billing, and operations teams to identify trends in denials, underpayments, and reimbursement discrepancies.
- Lead cross-functional initiatives to resolve payment issues and improve collections.
- Ensure compliance with third-party reimbursement requirements and documentation standards.
- Develop and update managed care strategies in collaboration with operational leaders, including defined goals, objectives, and performance tracking.
- Monitor market trends, regulatory changes, and competitive dynamics within the post-acute care industry.
- Support mergers and acquisitions by assessing payer contracts and integration strategies.
- Report payer relations activity and progress to senior leadership on a regular basis.
- Ensure proper documentation and tracking of expenses and reimbursement requests.
- Maintain confidentiality of sensitive payer and organizational information.
Requirements
- Bachelor’s degree in business, healthcare administration, or a related field preferred (or equivalent experience).
- Minimum of 5+ years of experience in payer relations, managed care contracting, or a post-acute healthcare setting.
- Experience in Durable Medical Equipment (DME), infusion therapy, or other post-acute services strongly preferred.
- Prior experience in sales or market development is a plus.
- Strong understanding of managed care contracting, reimbursement methodologies, and payer structures (Medicare, Medicaid, commercial).
- Proven track record of successful payer negotiations and contract management.
- Experience identifying and resolving denial and payment issues.
- Excellent analytical, financial, and problem-solving abilities.
- Strong organizational, communication, and interpersonal skills.
- Ability to work collaboratively in a matrixed environment and influence stakeholders at all levels.
- Self-motivated, results-oriented, and able to work independently.
- Ability to travel as needed (approximately 25%).
- Professional appearance and demeanor.
- Ability to maintain confidentiality and handle sensitive information.
Benefits
- Medical Insurance- multiple plans to choose from
- Dental & Vision Insurance
- Short Term Disability & Long Term Disability Options
- Life Insurance
- Generous PTO plan
- Paid Holidays
- 401K
- 401K match
- Competitive Pay
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
managed care contractingreimbursement methodologiespayer negotiationscontract managementfinancial analysisproblem-solvingmarket developmentDMEinfusion therapycontract performance modeling
Soft Skills
analytical skillsorganizational skillscommunication skillsinterpersonal skillscollaborative skillsinfluencing skillsself-motivatedresults-orientedconfidentialitypresentation skills
Certifications
Bachelor’s degree in businessBachelor’s degree in healthcare administration