Payer Contracting Manager, Transplant Program
Intermountain Health · Colorado, United States
FULL TIME
Job Description
Job Description: The Payer Contracting Manager, Transplant Program is responsible for the strategic management of payer and specialty network relationships that support Intermountain Health's transplant programs. This role brings expertise in transplant reimbursement, specialty network contracting, and complex payer negotiations, partnering closely with business development and operational leaders to expand transplant outreach agreements, strengthen referral networks, and drive program growth.
The position oversees all aspects of assigned contracts, including negotiation support, contract and relationship management, reimbursement issue resolution, rate optimization, and cross-functional collaboration. This role serves as the primary contracting lead for transplant-related payer agreements across Intermountain Health. This position can be performed remotely with business travel as-needed. Intermountain Health maintains employment registration in Utah, Idaho, Nevada, Colorado, Montana, and Wyoming. Currently, we are not hiring remote workers in the following states: Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings.
Manages all aspects of assigned payer relationships, including supporting contract language negotiation and management, rate and methodology research and negotiation, dispute resolution, and relationship management.
Maintains ongoing expertise of all assigned contracts, including contract/amendment language and structure, rates, methodologies, and contracted providers/facilities.
Ensures all contract language, documentation, negotiation, payment rate, payment methodology, contract storage, and escalated contract issues follow Payer Contracting standard practices.
Coordinates with Finance and Revenue Cycle leadership for the implementation of risk-based contracting, and proactive care, strategies and initiatives.
Coordinates with Legal and Compliance to ensure contract accuracy, regulatory compliance, and language consistency.
Provides leadership and mentorship to Payer Contracting Managers.
Risk-based Contracting
Relationship Management
Managed Care
Legal Practices
Demonstrated ability to synthesize extensive amounts of data into clear and concise summaries without sacrificing material details.
Experience negotiating complex payer agreements, transplant center of excellence arrangements, specialty network contracts, and/or other advanced reimbursement models, with a strong understanding of case rates, bundled payments, carve out agreements, and high acuity service reimbursement.
This is an exempt, full-time position. In addition to the annual salary, to show our commitment to you and assist with your transition,, we may offer a sign-on and relocation bonus when applicable. With this position, you are eligible to participate in the Annual Pay for Performance (AP4P) Plan. This plan enables Intermountain Health to provide leaders with an additional performance compensation opportunity. Ability to travel on a frequent basis to negotiate contracts with payers.
Ongoing need for employee to see and read information, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
Frequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
Key Bank Tower, Nevada Central Office, Peaks Regional Office Work City:
40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules.
The position oversees all aspects of assigned contracts, including negotiation support, contract and relationship management, reimbursement issue resolution, rate optimization, and cross-functional collaboration. This role serves as the primary contracting lead for transplant-related payer agreements across Intermountain Health. This position can be performed remotely with business travel as-needed. Intermountain Health maintains employment registration in Utah, Idaho, Nevada, Colorado, Montana, and Wyoming. Currently, we are not hiring remote workers in the following states: Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings.
Manages all aspects of assigned payer relationships, including supporting contract language negotiation and management, rate and methodology research and negotiation, dispute resolution, and relationship management.
Maintains ongoing expertise of all assigned contracts, including contract/amendment language and structure, rates, methodologies, and contracted providers/facilities.
Ensures all contract language, documentation, negotiation, payment rate, payment methodology, contract storage, and escalated contract issues follow Payer Contracting standard practices.
Coordinates with Finance and Revenue Cycle leadership for the implementation of risk-based contracting, and proactive care, strategies and initiatives.
Coordinates with Legal and Compliance to ensure contract accuracy, regulatory compliance, and language consistency.
Provides leadership and mentorship to Payer Contracting Managers.
Risk-based Contracting
Relationship Management
Managed Care
Legal Practices
Demonstrated ability to synthesize extensive amounts of data into clear and concise summaries without sacrificing material details.
Experience negotiating complex payer agreements, transplant center of excellence arrangements, specialty network contracts, and/or other advanced reimbursement models, with a strong understanding of case rates, bundled payments, carve out agreements, and high acuity service reimbursement.
This is an exempt, full-time position. In addition to the annual salary, to show our commitment to you and assist with your transition,, we may offer a sign-on and relocation bonus when applicable. With this position, you are eligible to participate in the Annual Pay for Performance (AP4P) Plan. This plan enables Intermountain Health to provide leaders with an additional performance compensation opportunity. Ability to travel on a frequent basis to negotiate contracts with payers.
Ongoing need for employee to see and read information, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
Frequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
Key Bank Tower, Nevada Central Office, Peaks Regional Office Work City:
40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules.
Details
| Company | Intermountain Health |
| Location | Colorado, United States |
| Type | FULL TIME |
| Niche | general |
