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Oak St. Health
Payor Relations & Contracting ManagerOak St. Health • Columbus, OH, United States
Payor Relations & Contracting Manager

Payor Relations & Contracting Manager

Oak St. Health • Columbus, OH, United States
3 hours ago
Salary
$60,300.00–$132,600.00 yearly
Job type
  • Full-time
Job description

Manager Of Contract Negotiation

We're building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger helping to simplify health care one person, one family and one community at a time.

The Manager of Contract Negotiation develops and maintains strategic relationships with physician partners across the Northern Ohio market, leading contract management and provider relations initiatives that support Commercial and Medicare lines of business.

In addition to managing these relationships, the Manager develops, reviews, analyzes, and executes provider contracts. They ensure proper implementation of negotiated agreements and monitor contract performance to align with accessibility, compliance, quality, financial, and cost objectives.

Key Responsibilities:

  • Lead the development and execution of innovative programs to advance contract negotiation initiatives across the organization.
  • Anticipate industry changes, evaluate their impact, and formulate strategic responses.
  • Design and implement systems to recruit providers, supporting network expansion and adequacy goals.
  • Conduct competitive analyses to inform reimbursement strategies.
  • Foster cross-functional collaboration to enhance provider compensation methodologies and analyze financial impacts of reimbursement models.
  • Recommend strategies to address cost challenges and drive cost-saving initiatives and settlement activities.
  • Support network development, maintenance, and optimization to achieve company and market objectives.
  • Mentor colleagues on best practices, processes, and responsibilities to strengthen team capabilities.

Required Qualifications:

  • 5 years of experience leading or supporting operational functions within healthcare administration or health insurance environments.
  • 3+ years managing provider relationships and overseeing contract management functions.
  • Demonstrated ability to partner with internal and external stakeholders to identify root causes, develop solutions, and drive issue resolution within established timelines.
  • Proficiency in Microsoft Word, Excel, and PowerPoint.

Preferred Qualifications:

  • 3+ years experience with provider contract negotiation or provider relations experience
  • Experience with EPDB (Enterprise Provider Database, SCM (Strategic Contract Manager), and Provider Data Management.
  • Experience with Commercial and Medicare lines of business.
  • Exceptional written and verbal communication skills, particularly with external stakeholders.
  • Strong critical thinking, problem-solving, and interpersonal skills.
  • Candidates residing in Ohio are strongly preferred.

Education:

  • Bachelor's degree or equivalent combination of education and professional work experience.

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range: $60,300.00 - $132,600.00

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

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Payor Relations & Contracting Manager • Columbus, OH, United States

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