Payor Relations Manager

Job Description

Location: Tampa, FL (Greater Metro Area)

We are seeking a Payor Relations Manager to support managed care contracting, payer strategy, and reimbursement optimization efforts for a large healthcare provider organization. This role is responsible for managing payer relationships, negotiating contracts, analyzing reimbursement performance, and supporting long-term managed care strategy initiatives.

This position is ideal for a healthcare contracting professional with strong negotiation experience, financial acumen, and the ability to balance revenue optimization with long-term payer partnership development.

Responsibilities:

• Manage day-to-day relationships with commercial, Medicare Advantage, and Medicaid managed care payer representatives
• Lead contract negotiations for new agreements and renewals, advocating for favorable rates, terms, and administrative provisions
• Analyze contract performance against benchmarks and identify underpayment trends requiring payer escalation
• Resolve high-dollar reimbursement disputes and coordinate payer-provider joint operating committee meetings
• Monitor payer policy changes, network adequacy requirements, and value-based contract milestones
• Collaborate with revenue cycle, finance, and legal teams on contract loading, fee schedule implementation, and compliance
• Develop and maintain a payer contract database with key terms, renewal dates, and performance metrics
• Prepare executive summaries on market trends, payer mix shifts, and competitive contract intelligence
• Support value-based contract management including quality metric tracking, shared savings calculations, and incentive reconciliation
• Negotiate single case agreements and letter of agreement terms for out-of-network situations
• Manage payer credentialing and network participation status for the organization and its providers
• Track legislative and regulatory changes impacting payer reimbursement and communicate strategic implications to leadership
• Represent the organization at payer advisory councils, industry conferences, and market forums
• Develop annual payer strategy recommendations including contract priorities, market positioning, and competitive analysis

Qualifications:

• Bachelor’s degree in Healthcare Administration, Business, or Finance required; MBA or MHA preferred
• Minimum 5 years of experience in managed care contracting, payer relations, or healthcare network management
• Proven contract negotiation skills with demonstrated success improving reimbursement terms
• Deep knowledge of Medicare, Medicaid, and commercial reimbursement methodologies
• Experience with contract management systems and financial modeling tools
• Strong executive communication and relationship management skills
• Knowledge of value-based care contract structures including shared savings, bundled payments, and capitation
• Strategic thinker with ability to balance short-term revenue goals with long-term payer partnership development

Schedule:

• Full-time position
• Standard business hours
• Standard full-time hours per pay period

Salary Range: The salary range for this position is approximately $90,000 – $115,000 annually ($43.27 – $55.29 per hour), based on experience and qualifications. Relocation assistance may be available for qualified candidates.

Interview Process:

• Selected candidates will participate in a multi-step interview process, including an initial screening with TalentLNX followed by interviews with department leadership.

Equal Opportunity Employer: TalentLNX is committed to equal employment opportunity and a diverse, inclusive workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.