Payer Relations Manager

Remote, Nationwide – Seeking Payer Relations Manager

Everybody Has A Role To Play In Transforming Healthcare

At Vituity you are part of a larger team that is driven by our purpose to improve lives. We are dedicated to transforming healthcare through our culture by working together to tackle healthcare’s most pressing challenges from the inside.

Join the Vituity Team. At Vituity we’ve cultivated an environment where passion thrives, and success comes through shared purpose. We were founded in a culture that values team accomplishments more than individual achievements, an approach we call “culture of brilliance.” Together, we leverage our strengths and experiences to make a positive impact in our local communities. We foster this through shared goals and helping our colleagues succeed, and we also understand the importance of recognition, taking the time to show appreciation and gratitude for a job well done.

Vituity Locations: Vituity has opportunities at 475 sites across the country, serving 9 million patients a year. With Vituity, if you ever need to move, you can take your job with you.

The Opportunity

• Monitors and manages all assigned payer projects including oversight, coordination, and management of payer issues across multiple regions and specialties.
• Gathers, reviews, and verifies all pertinent information to provide a summary on payer issues for each assigned payer.
• Recommends to Director of Payer Contracts the optimal resolution to each assigned payer.
• Resolves all payer-related issues with payers in a timely and efficient manner.
• Develops and maintains positive relationships with assigned payers, ensuring they are informed about challenges and opportunities on issue resolutions.
• Serves as primary point of contact with payers to address and resolve issues related to enrollment, billing, and collection challenges.
• Initiates and maintains effective channels of communication with payers and internal departments, addressing any concerns or issues that arise.
• Facilitates regular meetings with payers to review performance, address concerns, and discuss opportunities for improvement.
• Collaborates with internal departments to analyze root causes of payer-related issues and implement corrective actions.
• Provides regular updates on payers and payer policies to internal stakeholders including escalation of unresolved or recurring issues.
• Communicates with internal stakeholders through presentations, training documents, and reports.
• Works with Director of Payer Contracts to formulate strategies on assigned payers aimed at improving financial performance and ensuring smooth operations.
• Prioritizes decision making of payer-related issues based on the overall impact to Vituity.
• Identifies potential payer issues by actively monitoring payer KPIs and provides feedback to improve performance financial and/or operational performance related to payer issues.
• Consistently demonstrates capacity to manage and resolve urgent issues that arise.
• Supports other department projects or duties, as assigned.

Required Experience and Competencies

• College degree required.
• Minimum five years of experience in provider relations, payer relations, and claims processing required.
• 7-10 years’ experience in healthcare with a thorough understanding of payer policies and procedures, billing and collections, claim adjudication and processing, and credentialing and provider enrollment process required.
• Masters' degree in healthcare administration or equivalent preferred.
• Minimum five years of management and/or project management experience in healthcare preferred.
• Past experience and demonstrated ability to resolve complex issues preferred.
• Experience in establishing and maintaining strong payer relationship to obtain requested information timely.
• Experience in researching and analyzing payer-related information including but not limited to claims data and payer policies.
• Ability to effectively interact with all stakeholders both in written and verbal communication.
• Ability to effectively manage time and organize projects to accomplish goals thoroughly and accurately.
• Ability to think critically to identify underlying causes as well as solving problems with optimal solution.
• Expert knowledge of payer policies, coding and reimbursement rules, laws and regulations.
• Expert knowledge of healthcare billing and collection processes to provide appropriate guidance on addressing payer issues.
• Proficient in Microsoft Office Suite (PowerPoint, Word, Excel, Outlook, OneNote, OneDrive, SharePoint, Teams).

The Community

Even when you are working remotely, you are an important part of the Vituity Community. We offer plenty of opportunities to engage with other Vitans through a variety of virtual meet-and-greets, events and seminars.

• Monthly wellness events and programs such as yoga, HIIT classes, and more
• Trainings to help support and advance your professional growth
• Team building activities such as virtual scavenger hunts and holiday celebrations
• Flexible work hours
• Opportunities to attend Vituity community events including LGBTQ+ History, Día de los Muertos Celebration, Money Management/Money Relationship, and more

Benefits & Beyond*

Vituity cares about the whole you. With our comprehensive compensation and benefits package, we are mindful of what matters most, and support your needs of today and your plans for the future.

• Superior health plan options
• Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
• Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%
• Outstanding Paid Time Off: 3-4 weeks’ vacation, Paid holidays, Sabbatical
• Student Loan Refinancing Discounts
• Professional and Career Development Program
• EAP, travel assistance, and identify theft included
• Wellness program
• Purpose-driven culture focused on improving the lives of our patients, communities, and employees

We are excited to share the base salary range for this position is $85,170 - $106,465 exclusive of fringe benefits or potential bonuses. This position is also eligible to participate in our annual corporate Success Sharing bonus program, which is based on the company’s annual performance. If you are hired at Vituity, your final base salary compensation will be determined based on factors such as skills, education, and/or experience. We believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please speak with a recruiter for more details.

We are unified around the common purpose of transforming healthcare to improve lives and we believe everyone has a role to play in that. When we work together across sites and specialties as an integrated healthcare team, we exceed the expectations of our patients and the hospitals and clinics we work in. If you are looking to make a difference, from clinical to corporate, Vituity is the place to do it. Come grow with us.

Vituity does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Vituity is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity.

*Benefits for part-time and per diem vary. Please speak to a recruiter for more information.

Applicants only. No agencies please.