About the role

Manager - Payer Relations managing healthcare partnerships. Reporting to SVP - Payer Contracting, focusing on scaling the healthcare industry.

Responsibilities

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 - $108,893.73. 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 [email protected] to request an accommodation.
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.