Payor Relations Manager

Job Description

Location: Tampa, FL (Greater Metro Area)

We are seeking a Payor Relations Manager to own the strategic relationship with commercial and government payer partners. This role negotiates favorable contract terms, resolves escalated reimbursement disputes, and ensures the organization maximizes revenue under value-based and fee-for-service arrangements across its entire payer portfolio.

Payer relationships are where strategy meets revenue. Every percentage point you negotiate in a rate increase translates to millions in annual reimbursement. Every underpayment you identify and escalate is money that belongs to the organization. This role is for someone who can sit across the table from a payer representative, understand the financial implications of every contract term, and advocate effectively for the organization while maintaining the relationship.

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 prohibits discrimination and harassment of any kind. We are dedicated to building a diverse workforce and fostering an inclusive work environment where all employees and candidates are treated with respect and dignity. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or any other protected status under applicable law. We actively seek to recruit, develop, and retain talented individuals from diverse backgrounds and we encourage all qualified candidates to apply for our job opportunities.