Manager - Payer Relations

Overview

Department: Payer Relations & Contracting

Location: 600 City Parkway West 10th Floor, Orange, CA 92868

Compensation: $84,852 - $108,894 / year

We are currently seeking a highly motivated Manager - Payer Relations. This role will report to the SVP - Payer Contracting and enable us to continue to scale in the healthcare industry.

• Owns Health Plan relationships pertaining to day to day issues for all medical groups
• Drive root cause solutions
• Ensure Proper administration of DOFRs
• Oversee and design CAPs arising from Health Plans
• Oversee project(s) from Health Plans
• RFPs for vendors
• Amendments
• Routine communication / requests to Health Plans
• Project manage all aspects of Payer and Provider contracting
• Provide guidance for Payer Relations Associates
• Efficiently delegate and coordinate the flow of contracts to all relevant stakeholders
• Interpret and assess risk for provider-facing and payer-facing agreements for time sensitive negotiations
• Perform Delegation Oversight / Compliance analysis to reduce Astrana’s risk exposure and likelihood of incurring penalties, sanctions, and or deductions
• Work directly with Claims, Configuration, Business Development, and Data Management teams to gather reports regarding data to support proposal

• Bachelor’s Degree required or equivalent experience in the healthcare industry
• Minimum of 2-3 years of contracting / negotiation / payer / provider relations experience in the healthcare industry
• Technical backgrounds are a plus with a passion for the healthcare industry

• High level of comfort working with numbers and large bodies of text
• Strong problem-solving skills with ability to showcase a methodical approach to troubleshooting
• You are meticulous, highly organized, and able to engage in exhaustive investigation when initial information is vague
• Excellent communication skills – both verbal and written. Experience in technical writing is a plus
• Understands and has experience working within the delegated network environment
• Strong comfortability with Microsoft Office Suite (Excel, Word, PowerPoint)
• Very knowledgeable with EZ-Cap and able to understand and work with proprietary software applications – preferred

• Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. In office days will alternate between offices at 600 City Parkway West, Orange, CA 92868 and 1600 Corporate Center Dr, Monterey Park, CA 91754.
• The total compensation target pay range for this role is: $84,852.26 - $. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need.

If you require assistance in applying for open positions due to a disability, please email us at humanre to request an accommodation.

Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.