National Market Access Manager
RemoteUnited States or France
Job Summary
Lead all third-party payer contract negotiations, develop and maintain a national contracting strategy, and manage regional agreements to optimize revenue. Analyze existing terms for re-negotiation, resolve reimbursement disputes, and serve as the primary business owner for managed care relationships with Medicare, Medicaid, and other payors. Oversee department policies, create fee schedule matrices, and model payment analysis reports using Excel and SAS data. Monitor regulatory requirements, escalate contract provisions to management, and act as a designated participant on the Executive Leadership team. Serve as the conduit between Billing, Payor Relations, and third-party payors to ensure timely resolution of coverage and language issues.
Required Qualifications
- Bachelor degree in Business Administration, Finance, Accounting and/or Information Systems
- Minimum 8 years healthcare administrative experience
- Must be vaccinated against the novel COVID-19 virus variants or provide proof of approved exemption
- Ability to speak and hear well enough to communicate clearly and understandably with sufficient volume to ensure an accurate exchange of information in normal conversational distance, over the telephone, and in a group setting
- Ability to continuously operate a personal computer for extended periods of time (4 or more hours)
- Mental acuity sufficient to collect and interpret data, evaluate, reason, define problems, establish facts, draw valid conclusions, make valid judgments and decisions
- Ability to work outside core business hours as needed and take ownership of issue-resolution regardless of hours worked
Desired Qualifications
- Master's Degree preferred
- Experience working with multiple state payors preferred
- Ability to process and understand complex information related to working in a managed care environment
- Strong familiarity with managed care terminology and managed care contact provisions
- Experience in compiling, coordinating, and analyzing payor contract regulatory requirements and contract language
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.