Payer Strategy & Contracting Principal

CenterWell Senior Primary Care

. Develop and execute payer-specific and market-specific action plans aligned with enterprise payer strategy, growth priorities, and operational capacity .

Posted 11/12/2026full-timeRemote • United StatesLead💰 $138,900 - $191,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in payer contracting, reimbursement methodologies, and financial analysis, with a strong ability to lead negotiations and implement payer agreements. Proven track record in stakeholder management and presenting strategic recommendations to leadership.

Highest-signal resume keywords

Payer ContractingReimbursement MethodologiesFinancial AnalysisNegotiation SkillsStakeholder Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Contract NegotiationReimbursement AnalysisBusiness Case DevelopmentFinancial Performance EvaluationMarket Dynamics Analysis

Soft Skills

Analytical SkillsProblem-Solving SkillsExecutive Communication Skills

Industry Keywords

Managed CareHealthcare FinanceValue-Based ReimbursementFee-For-ServiceHome Health

About the role

Key responsibilities & impact

Develop and execute payer-specific and market-specific action plans aligned with enterprise payer strategy, growth priorities, and operational capacity
Evaluate payer opportunities using referral trends, membership and enrollment data, reimbursement, financial performance, market dynamics, operational capacity, and strategic fit
Analyze payer and market performance to identify growth opportunities, network gaps, underperforming agreements, renewal priorities, reimbursement opportunities, and termination risks
Develop recommendations on payer participation, contracting priorities, reimbursement strategies, and preferred provider opportunities
Lead development, negotiation, renewal, and amendment of national, regional, state, and local payer agreements
Evaluate reimbursement methodologies and contract terms
Develop financial analyses, business cases, rate recommendations, and contract feasibility assessments
Negotiate reimbursement, operational, administrative, and other material contract provisions
Coordinate stakeholder review, leadership approvals, agreement execution, renewal planning, and contractual milestones
Present contracting strategies, recommendations, risks, and business cases to leadership and governance forums
Lead cross-functional implementation of new and amended payer agreements
Establish implementation owners, deliverables, milestones, dependencies, and escalation pathways
Develop workflows, communications, reporting, and processes for payer agreement implementation
Resolve payer-related issues involving referrals, authorizations, eligibility, denials, payment, reimbursement, and contract requirements
Serve as primary business and contracting contact for assigned payer relationships
Conduct recurring payer business reviews focused on performance, operational issues, growth, quality, and strategic priorities
Expand network access, referral volume, preferred provider relationships, care coordination, quality initiatives, and value-based arrangements
Monitor payer and contract performance against negotiated terms, reimbursement assumptions, volume expectations, and financial measures
Identify reimbursement leakage, unfavorable trends, and operational performance drivers
Develop corrective action plans with Finance, Revenue Cycle, Operations, and other stakeholders
Assess financial impact of reimbursement changes and alternative payment methodologies
Provide leadership reporting and recommendations on contract performance, financial risks, growth opportunities, renewals, and corrective actions
Lead collaboration across Operations, Sales, Finance, Revenue Cycle, Clinical, Legal, Compliance, Business Development, and other stakeholders
Prepare business cases, recommendations, and decision materials for contracting and payer governance forums
Maintain contract documentation, decision records, action logs, implementation plans, and renewal milestones
Identify and escalate financial, operational, contractual, compliance, and implementation risks
Serve as a subject matter resource on payer relationships and contracting strategies

Requirements

What you’ll need

Bachelor’s degree in Business, Healthcare Administration, Finance, or a related field, or equivalent relevant professional experience
Five or more years of experience in managed care, payer contracting, provider relations, payer account management, healthcare finance, business development, or healthcare operations
Demonstrated experience interpreting payer agreements and reimbursement structures and leading contract negotiations
Strong financial acumen and ability to evaluate reimbursement methodologies, contract economics, and business cases
Strong analytical, negotiation, problem-solving, stakeholder management, and executive communication skills
Experience in home health, post-acute care, and/or managed care preferred
Knowledge of episodic, fee-for-service, and value-based reimbursement payment models, authorization requirements, and revenue cycle processes preferred
Experience leading complex initiatives across multiple functional and operational stakeholders preferred
Ability to manage multiple payer priorities, deadlines, negotiations, and implementation activities independently preferred
Experience with contract performance reporting, reimbursement analysis, and payer-provider issue resolution preferred
Experience presenting contracting strategies, business cases, and recommendations to senior leadership preferred
Minimum home internet speed of 25 Mbps download and 10 Mbps upload
Dedicated workspace without ongoing interruptions to protect member PHI / HIPAA information

Benefits

Comp & perks

Bonus incentive plan based on company and/or individual performance
Medical benefits
Dental benefits
Vision benefits
401(k) retirement savings plan
Paid time off
Company holidays
Personal holidays
Paid parental leave
Paid caregiver leave
Short-term disability
Long-term disability
Life insurance
Whole-person well-being and personal wellness support
Remote work arrangement
Occasional travel to Humana offices for training or meetings