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Payer Contract Manager Sr

Key Facts

Remote From: 
Full time
Senior (5-10 years)
101 - 145K yearly
English

Other Skills

  • Relationship Management
  • Decision Making
  • Collaboration
  • Communication
  • Leadership
  • Analytical Thinking
  • Relationship Building
  • Problem Solving

Roles & Responsibilities

  • Bachelor's degree in finance, healthcare administration, or related field; or 10+ years of experience in payer contracting for a health system or health plan as degree equivalent
  • Minimum seven (7) years of experience performing financial/medical data/payer mix analysis or contract negotiation in a healthcare environment (acute care setting experience preferred)
  • Experience with medical and pricing terminology (e.g., DRG, RUG, APC, RVU, Conversion Factors)
  • Behavioral health background with knowledge of Washington Medicaid; experience in payer or provider contracting; local to Washington State preferred

Requirements:

  • Develop and implement contracts with third-party payers on behalf of MultiCare Health System and its affiliates, ensuring consistent payer relationships aligned with MultiCare’s vision and priorities
  • Lead negotiations with assigned payers to establish payment terms across multiple reimbursement models, including fee-for-service, value-based, and gain/risk sharing arrangements
  • Manage the overall payer relationship, advise senior leadership on product participation, and continually evaluate payer relationships to improve revenue, reduce costs, and improve access for patients
  • Negotiate contract language that complies with applicable state and federal laws/regulations, maintains consistency across payers, and mitigates financial, legal, or operational risk to MultiCare

Job description

You Belong Here.

At MultiCare, we strive to offer a true sense of belonging for all our employees. Across our health care network, you will find a dynamic range of meaningful careers, opportunities for growth, safe workplaces, and flexible schedules. We are connected by our mission - partnering and healing for a healthy future - and dedicated to the health and well-being of the communities we serve.

Seeking candidates with a behavioral health background, knowledge of Washington Medicaid, experience in payer or provider contracting, local to Washington State preferred


FTE: 1.0, Shift: Day, Schedule: Business Hours

Position Summary

The Senior Payer Contract Manager is responsible for developing and implementing contracts with third party payers on behalf of MultiCare Health System and its affiliates. This role ensures MultiCare, and our affiliates have consistent and well-functioning relationships with payers over time, in alignment with MultiCare’s vision and strategic priorities. The Manager will lead negotiations with assigned payers to include payment terms based on multiple reimbursement models, including fee-for-service payment terms, value-based payment terms, and gain/risk sharing arrangements.

The Manager serves as the lead managing the overall payer relationship, makes recommendations to Sr. Leadership on product participation, and will continually evaluate the payer relationship for opportunities to improve revenue, lower the cost of doing business, and to improve MultiCare’s access to patents. The Manager is accountable for negotiating contract language that aligns with all State and Federal laws and regulations, is consistent across payers, and does not expose MultiCare financial, legal, or operational risk to MultiCare or the payer.

Requirements

  • Bachelors degree with a major in finance, Healthcare administration, or related field; or 10+ years’ experience in Payer Contracting for a Health System or Health Plan as degree equivalent
  • Minimum seven (7) years of experience performing financial/medical data/payer mix analysis or contract negotiation in a healthcare environment, health system or health plan; acute care setting experience preferred
  • Experience with medical and pricing terminology to include but not limited to DRG, RUG, APC, RVU, Conversion Factors

Why MultiCare?

  • Rooted in the local community – Partnering with patients, families and neighbors across the Pacific Northwest for more than 140 years

  • Growth and education – Competitive tuition assistance, award-winning residencies, fellowships and career development to invest in your future

  • Well-being and support – Generous PTO, Code Lavender and Employee Assistance Programs to help you maintain balance and feel cared for at work and in life

  • Living our values – Respect, integrity, kindness and collaboration guide how we care for patients, communities and each other

  • Belonging for all – Employee Resource Groups, inclusion initiatives and outreach programs support a workplace where every voice is valued

  • Pacific Northwest lifestyle – Work and live where natural beauty, adventure and strong community connections are part of everyday life

Pay and Benefit Expectations

We provide a comprehensive benefits package, including competitive salary, medical, dental and retirement benefits and paid time off. As required by various pay transparency laws, we share a competitive range of compensation for candidates hired into each position. The pay scale is $100,547.00 - $144,685.00 USD. However, pay is influenced by factors specific to applicants, including but not limited to: skill set, level of experience, and certification(s) and/or education. If this position is associated with a union contract, pay will be reflective of the appropriate step on the pay scale to which the applicant’s years of experience align.

Associated benefit information can be viewed here.

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