Payer Contracting Manager for Children's Health

Payer Contracting Manager

The Payer Contracting Manager is responsible for effective management of assigned payer contracts, including supporting contract negotiations and relationships. This leadership role manages all aspects of assigned payer contracts, including contract management, relationship management, dispute resolution, rate negotiation, and internal coordination. This position specifically supports the Children's Health Payer Contracting in Nevada to include the Pediatric Clinically Integrated Network, the Professional and Facility contracting needed for Intermountain Health's Nevada Children's Hospital.

This position can be performed remotely with business travel as-needed. Intermountain Health maintains employment registration in Utah, Idaho, Nevada, Colorado, Montana, and Wyoming. Candidates in other locations may be considered. Currently, we are not hiring remote workers in the following states: CA, CT, HI, IL, NY, RI, VT, and WA. Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings.

Essential Functions

• Manages all aspects of assigned payer relationships, including supporting contract language negotiation and management, rate and methodology research and negotiation, dispute resolution, and relationship management.
• Maintains ongoing expertise of all assigned contracts, including contract/amendment language and structure, rates, methodologies, and contracted providers/facilities.
• Ensures all contract language, documentation, negotiation, payment rate, payment methodology, contract storage, and escalated contract issues follow Payer Contracting standard practices.
• Represents Payer Contracting and Intermountain Health in key relationships, including leading Joint Operating Committees.
• Establishes and maintains effective long-term relationships with highly aligned payers.
• Coordinates with Finance and Revenue Cycle leadership for the implementation of risk-based contracting, and proactive care, strategies and initiatives.
• Coordinates with Legal and Compliance to ensure contract accuracy, regulatory compliance, and language consistency.
• Provides leadership and mentorship to Payer Contracting Managers.

Skills

• Contracting Strategies
• Healthcare Contracts
• Negotiations
• Payer Contracting
• Proactive Care
• Risk-based Contracting
• Relationship Management
• Managed Care
• Legal Practices
• Leadership

Required Qualifications

• Experience leading and supporting complex negotiations.
• Experience in a professional role that requiring effective verbal and written communication to present advanced topics in a clear, concise, polished, and professional manner.
• Demonstrated ability to synthesize extensive amounts of data into clear and concise summaries without sacrificing material details.
• Experience leading teams, including cross-functional teams.
• Demonstrated experience mentoring teams and caregivers.

Preferred Qualifications

• Proven experience in payer contracting, including full-cycle negotiation and contract redlining.
• Demonstrated success negotiating pediatric or children's health contracts, from either the provider or payer perspective.

Additional Information

• This is an exempt, full-time position. Pay offers are determined by prior years of relevant experience within the established pay range.
• In addition to the annual salary, to show our commitment to you and assist with your transition, we may offer a sign-on and relocation bonus when applicable. With this position, you are eligible to participate in the Annual Pay for Performance (AP4P) Plan. This plan enables Intermountain Health to provide leaders with an additional performance compensation opportunity. The AP4P award opportunities are calculated as a percentage of your base salary. Awards are paid out based on attainment of selected Board-approved goals.
• Ability to travel on a frequent basis to negotiate contracts with payers.
• Ongoing need for employee to see and read information, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
• Frequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
• Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
• May be expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles.

Location: Nevada Central Office

Work City: Las Vegas

Work State: Nevada

Scheduled Weekly Hours: 40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$58.62 - $90.48

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.