Jobs in the United States

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Added 1 min ago
Cyber Security Engineer
Academy Sports
Katy, TX
Security, Security Operations Management, Security Policy Development, Managed Cloud Security Services, Identity Systems, Networking Experience, Offensive Security
Added 2 mins ago
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Assistant Manager
Factory Stores H.F.D. No. 55, Inc.
Leeds, AL
- $17.75 to $22.3 USD / hour
Assist Store Director & Associate Store Manager with recruiting, training and development efforts, if needed.
Added 2 mins ago
FS
Associate Manager
Factory Stores H.F.D. No. 55, Inc.
Livingston, NJ
- $26.25 to $32.85 USD / hour
Partner with Store Director and management team to curate a collaborative working environment for all associates.
Added 2 mins ago
Service Management - Analyst, Global Public Sector, Early Talent
Salesforce, Inc.
IN
…scale. We offer job shadowing, mentorship programs, talent development courses, and much…
Added 2 mins ago
Global GTM Delivery Leader
USA-Medtronic MiniMed, Inc 1017
Virtual, GA
…at scale. This leader will collaborate closely with Product Management, Enterprise Architecture, Platform Engineering, Business Stakeholders, and external partners to ensure successful…
Added 3 mins ago
Vice President, Total Rewards
Travere
Remote, United States
· Anticipate the total rewards implications of organizational change, business growth and potential business development activity.
Added 4 mins ago
Accessibility Lead Vice President - Digital Agentic
JPMC page
Seattle, WA
Provide strategic and technical accessibility leadership throughout the product lifecycle. You will partner with Product, Design, Engineering, Quality Assurance, Research, Risk, Controls,…
Added 5 mins ago
SV
Senior Director, PACE
Sutter Valley Hospitals
United States
- $165,339.2 to $264,555.2 USD / year
…exhaustive, but are merely the most descriptive of the current job. Management reserves the right to revise the job description or require that other tasks be performed when the…
Added 5 mins ago
Clinical Specialty Pharmacist
Ascension
Austin, TX
Partner with clinical staff to provide expert drug information and enhance treatment outcomes.
Added 5 mins ago
Global Marketing Director, Oncology
GlaxoSmithKline LLC
Upper Providence, PA
…improve the lives of patients around the world. They lead the development of insight-driven global product strategies and plans, deliver ambitious long-range forecasts, enable outstanding…
Added 5 mins ago
CHC Service Coordinator (Care Management, Home & Community Based)- Lackawanna County (Hybrid)
UPMC
Moosic, PA
We are seeking candidates that have a strong background in case management and care coordination, experience conducting in-home assessments and visits, and a demonstrated ability to work…
Added 5 mins ago
DA
Contract Analyst
Devereux Advanced Behavioral Health
Villanova, PA
- $35 to $40 USD / hour
…reimbursement analysis. Working 24-28 hours per week, you'll partner with finance, admissions, operations, and program leadership to optimize contract performance, support strategic…
Added 5 mins ago
Principal Architect, Applications & Integration
Dorman Products, Inc.
Colmar, PA
Added 5 mins ago
Manager, Compliance Business Partner
Olympus Corporation of the Americas
Center Valley, PA
Working in close alignment with the Sr. Director, Compliance Officer, Americas & RAC Business Partner, Global (Sr. Director), the Manager, Compliance Business Partner will work to develop…
Added 5 mins ago
CHC Service Coordinator (Care Management, Home & Community Based)- Beaver County (Hybrid)
UPMC
Beaver, PA
We are seeking candidates that have a strong background in case management and care coordination, experience conducting in-home assessments and visits, and a demonstrated ability to work…
Added 5 mins ago
Senior Director, Technology Compliance & Regulatory Engagement
SEI INVESTMENTS COMPANY
Oaks, PA
…policies, procedures and controls related to SEI's technology development, deployment and environment meet applicable regulatory expectations and are clearly understood, well-positioned,…
Added 5 mins ago
Logistics Engineer
Alten USA
Macungie, PA
…electric vehicles. With 3,000+ experts across North America, we partner with leading companies in aerospace, medical devices, robotics, automotive, commercial vehicles, EVs, rail, and…
Added 5 mins ago
Lead Executive Administrative Assistant
TransUnion LLC
Crum Lynne, PA
Added 5 mins ago
Branch Office Administrator
Edward Jones
New Kensington, PA
Behind everything we do is our purpose: We partner for positive impact to improve the lives of our clients and colleagues, and together, better our communities and society. We are an…
Added 6 mins ago
DA
Finance Specialist - Accounts Payable
Devereux Advanced Behavioral Health
Newfoundland, PA
- $19.36 to $22.07 USD / hour
…support, personalized career coaching, and mentoring/professional development. Learn more at…
Added 6 mins ago
Residential Sales Professional
Rentokil North American Pest Control
Souderton, PA
Added 6 mins ago
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Recruiting Coordinator (3-month Temporary)(8011)
TSMC
San Jose, CA
- $32 to $39 USD / hour
…Washington D.C., our team thrives in areas such as Account Management, Technical Customer Support, Business Operations, and more. At TSMC North America, we prioritize employee growth by…
Added 6 mins ago
Staff Software Development Engineer – iOS
CVS Health
Remote, United States
…are seeking a highly skilled and innovative Staff Software Development Engineer – iOS to join our growing digital engineering organization. This Staff Engineering role offers the…
Added 6 mins ago
Associate Director, Market Access Contracting & Pricing - 340B
Incyte Corporation
Chadds Ford, PA
…for patients with unmet medical needs. Through the discovery, development, and commercialization of proprietary therapeutics, Incyte has established a portfolio of first-in-class medicines…
Added 6 mins ago
Security Automation Engineer
TransUnion LLC
Crum Lynne, PA

Brault

Manager, Payer Contracting

San Dimas, CA, United States

$75,000 to $90,000 USD / year

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Job details

Pay: $75,000 to $90,000 USD / year
Experience: 3–5 years of experience in revenue cycle management, managed care, or a related healthcare financial role, with 2 + years’ experience healthcare payer contracting.
Posting language: English
Posted: Nov 3, 2026

Original job description

Description Position Summary The Payer Contract Specialist is responsible for supporting the negotiation, implementation, and management of payer contracts to ensure optimal reimbursement and compliance. This role analyzes contract terms, evaluates reimbursement methodologies, monitors payer performance, and collaborates with internal stakeholders to ensure accurate interpretation and execution of payer agreements.

Essential Duties and Responsibilities

Contract Development & Negotiation – These responsibilities performed in conjunction with Chief Compliance Officer/General Counsel

Establish or renew contracts under new Tax IDs as needed.
Create and maintain contract summary forms for all clients
Monitor contract termination dates and coordinate timely renewals, renegotiations, or terminations in alignment with client directives.
Process contract terminations.
Ensure all payer contracts and related documents, including but not limited to new agreements, notices, amendments and terminations, are maintained following company file storage protocols
Gather and analyze data to support negotiation strategy, rate improvements, alternate payment models and other opportunities for revenue cycle improvements.
Assist with the preparation and review of payer contracts, amendments, and fee schedules.

Payer Contract Module Ownership Serve as the Owner/Subject Matter Expert for the payer contract module in Athena.

Maintain comprehensive knowledge of the Payer Contract Module (client- and payer-specific), including:
Initial fee schedule uploads and ongoing maintenance (commercial and governmental).
Creation and configuration of rule-based logic.
Daily monitor variance reporting to identify needs for additional or updated rules, flag emerging payer trends, and escalate inappropriate payer behavior to leadership (such as underpayments)

Payer Policy Monitoring & Analysis

In conjunction with Chief Compliance Officer/General Counsel, monitor, interpret, and communicate payer policy updates, coverage determinations, and regulatory changes to cross-functional teams, ensuring alignment with internal processes.
Prior to contract expiration, review payer behavior, utilizing analytical tools (e.g., Impact Analysis Report) to recommend revised rates and support negotiation efforts to maximize revenue reimbursement for clients.
Prepare reports and dashboards that summarize contract metrics and financial outcomes as needed

Internal & External Collaboration

Participate in monthly or quarterly client meetings as a subject matter expert, offering insights into contract performance, opportunities for improvement, and recommended changes.
Notify client managers of contracts approaching renegotiation or termination windows.
Build and maintain positive relationships with payer Provider Representatives.
Attend key industry conferences and networking events.
Participate in team meetings to address issues related to payment terms, underpayments, and emerging contract-related trends.
Partner with revenue cycle teams to resolve contract-related payment issues and if necessary, to assist with appeals or reconsiderations for underpaid or denied claims
Provide guidance on contract interpretation to internal departments, including coding, billing, and patient access.
Work closely with legal, compliance, operations, and clinical departments during contract execution and renewals.
Communicate contract updates and reimbursement changes to key stakeholders.
Support implementation of new payer programs, reimbursement models, or operational changes.

Requirements

Knowledge, Skills, & Abilities

Intermediate skills in Microsoft Outlook, Excel, PowerPoint and Word.
Proficient with Adobe
Effective written and verbal communication skills.
Experience with Laserfiche (document storage) preferred but not required.
Knowledge of healthcare payer contracting, including commercial and government payers (Medicare, Medicaid, managed care)
Knowledge of payer contract terms, fee schedules, amendments, notices, and termination provisions.
Knowledge of payer policies, coverage determinations, and regulatory requirements affecting reimbursement.
Knowledge of data analysis and financial reporting related to contract performance and payer behavior.
Experience with revenue cycle operations, including billing, coding, payment posting, underpayment analysis, clearinghouse, and appeals.
Working knowledge of practice management or EHR systems, preferably Athena IDX, payer contract modules.
Familiarity or experience with Payer Price or similar payer rate transparency tool.
Proven track record of successful payer contracting negotiations.
Ability to analyze, evaluate, and apply knowledge of market and healthcare trends to effectively convey the value of a contract.

Education & Experience Requirements

Bachelor's degree in a related field such as healthcare administration or business preferred.
3–5 years of experience in revenue cycle management, managed care, or a related healthcare financial role, with 2 + years’ experience healthcare payer contracting.

Travel

As this is a role that covers the entire corporation, travel may include trips within the US and overnight travel should be expected. Travel expectations would be 10-15% of the time client visits, conferences, and other industry-related events.

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