Position: Manager, Payer Contracts
Location: Los Angeles, CA
Employment Type: Full Time
Compensation: Up to $173k + Bonus
FocusPoint Talent Solutions – Confidential Healthcare Client
Our client, a respected healthcare organization, is seeking an experienced Manager, Payer Contracts to lead payer strategy, contract negotiations, and revenue integrity functions. This role is ideal for a seasoned managed care professional who excels at building payer relationships, driving financial performance, and leading operational improvements.
About the Role
The Manager, Payer Contracts oversees the full lifecycle of payer agreements, including negotiation, execution, compliance, and performance monitoring. This leader partners closely with Finance, Revenue Cycle, and operational teams to ensure accurate reimbursement, strong payer partnerships, and optimized contract outcomes.
Key Responsibilities
- Serve as the primary liaison for payer contracting, negotiations, and issue resolution.
- Develop negotiation strategies, contract language recommendations, and financial terms aligned with organizational goals.
- Conduct financial modeling, reimbursement analysis, and “what‑if” scenario modeling to support contract decisions.
- Maintain and manage all payer agreements, amendments, renewal timelines, and contract files.
- Oversee implementation of contract terms within internal systems and validate accuracy.
- Ensure compliance with payer requirements, including annual updates and price transparency obligations.
- Maintain payer scorecards and performance dashboards to support renegotiation and financial planning.
- Lead denial management operations, ensuring denials are tracked, trended, appealed, and resolved effectively.
- Collaborate with revenue‑producing departments to ensure accurate daily charging and timely correction of discrepancies.
- Supervise and develop the Contract Analyst and other assigned staff.
- Communicate payer policies, updates, and contract changes to internal stakeholders.
Required Qualifications
- Bachelor’s degree required (business, finance, economics, or healthcare preferred).
- Minimum 7 years of recent experience in hospital, medical, or healthcare insurance environments with direct payer contracting responsibilities.
- Demonstrated expertise in payer contract negotiation, administration, and financial analysis.
- Advanced Excel skills, including modeling and complex formulas.
- Experience with hospital billing systems and financial reporting tools.
- Strong communication, analytical, and problem‑solving skills.
- Ability to lead teams, manage competing priorities, and drive measurable outcomes.
Preferred Qualifications
- Master’s degree in healthcare economics, healthcare policy, or finance.
- 10+ years of progressive hospital payer contracting experience.
- Prior experience supervising payer contracting or revenue integrity staff.
What Makes This Opportunity Attractive
- High‑impact role influencing payer strategy and financial performance.
- Direct visibility with senior leadership.
- Opportunity to shape payer relationships and drive operational improvements.
- Stable, mission‑driven healthcare environment.
Why Work with FocusPoint
As a trusted staffing partner to industry-leading companies, FocusPoint provides access to roles that align with your professional goals, and we advocate for your success throughout the recruitment process. Our team understands appropriate skillsets and takes a consultative approach ensuring that each match is grounded in both experience and fit.
How to Apply
To ensure confidentiality and alignment with our client’s hiring process, all applications must be submitted through FocusPoint. Please do not attempt to contact the client directly. Interested candidates should reach out to FocusPoint’s recruitment team with any questions.
About FocusPoint:
FocusPoint specializes in connecting top-tier professionals with exceptional opportunities in accounting, technology, healthcare, and leadership. We prioritize building meaningful connections, ensuring candidates find roles that align with their skills, goals, and passions.
Accounting, Technology and Leadership Staffing Agency
Pay: $107,952.00 - $172,723.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Relocation assistance
- Vision insurance
Application Question(s):
- Are you able to reliably commute to Los Angeles, CA or relocate before starting work?
- Describe your experience negotiating commercial payer contracts, including any specific payers you’ve worked with.
- Have you previously overseen denials management or appeals processes?
- Have you built financial impact models for payer proposals using Excel or similar tools?
Education:
Experience:
- negotiating payer contracts: 1 year (Required)
- hospital, medical group, or health insurance environment: 1 year (Required)
- financial modeling or advanced Excel: 1 year (Required)
Work Location: On the road
