Manager, Payer Relations, Contracting, Credentialing

Northpoint Recovery

. Serve as the primary operational relationship owner for assigned health plans and payer partners .

Posted 10/31/2026full-timeRemote • Idaho • United StatesMid-LevelSenior💰 $70,000 - $90,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managed care contracting, payer negotiation strategies, and provider credentialing processes. Proficient in analyzing reimbursement performance and developing scalable operational solutions to enhance patient access and financial outcomes.

Highest-signal resume keywords

Managed Care ContractingPayer NegotiationProvider CredentialingReimbursement AnalysisMicrosoft Office Suite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payer EngagementContract ManagementFinancial Impact AnalysisHCPCS/CPT CodingDelegated Credentialing Workflows

Soft Skills

Attention to DetailProblem DiagnosisRelationship BuildingOrganizational SkillsCommunication Skills

Industry Keywords

Health PlansPayer PartnersRevenue Cycle ManagementUtilization ReviewFee-for-Service Reimbursement

About the role

Key responsibilities & impact

Serve as the primary operational relationship owner for assigned health plans and payer partners
Develop and maintain strategic relationships with payer representatives, network leaders, contracting teams, and other stakeholders
Establish a structured payer engagement cadence for high-impact payer relationships
Identify and escalate payer issues affecting patient access, reimbursement, authorization, claims payment, or operational performance
Partner with Revenue Cycle Management and Utilization Review leadership on payer issue resolution
Monitor payer and market developments for financial, operational, and access opportunities or risks
Support payer strategy for new markets, de novo facilities, acquisitions, new service lines, and geographic expansion
Maintain a payer opportunity and escalation pipeline
Provide executive-level reporting on payer relationships, negotiations, network development, reimbursement opportunities, and material risks
Develop payer negotiation strategies with the EVP of Revenue Cycle Management and Finance
Build scalable multi-state licensing and credentialing processes
Evaluate reimbursement performance and identify contracts or rates requiring renegotiation
Maintain payer contract summaries covering reimbursement terms, authorization requirements, timely filing provisions, appeals, exclusions, and termination provisions
Quantify the financial impact of proposed rate changes and contract amendments with RCM analytics
Identify opportunities to expand network participation and improve patient access
Ensure negotiated contract terms are operationalized across Admissions, Utilization Review, Clinical Operations, Billing, and other functions
Manage the full lifecycle of contract management, negotiations, rate increases, HCPCS/CPT requirements, and professional services
Manage in-network and out-of-network contracting and negotiations for the organization and employed providers
Coordinate credentialing and recredentialing applications with clinical operations, licensing agencies, insurance carriers, and other organizations
Maintain licensing, contracting, and credentialing databases and develop related processes and procedures
Monitor entity-specific, accrediting organization, payer, state, and federal requirements and implement necessary changes
Analyze reimbursement by payer, authorization barriers, contractual adjustments, overpayments, underpayments, out-of-network exposure, network adequacy, rate performance, contract compliance, and patient access barriers
Perform other duties as assigned

Requirements

What you’ll need

Bachelor’s degree in business administration, health management, or commensurate experience required
Minimum of five (5) years of experience in managed care contracting and provider credentialing
Minimum of three (3) years of hospital and/or payer negotiation and payer analysis experience
Knowledge of fee-for-service and/or fee-for-value reimbursement methods, delegated credentialing workflows, and working knowledge of all major payers
Strong ability to synthesize information, distill takeaways and next steps, diagnose problems, identify patterns, and develop targeted solutions
Self-starter able to organize processes, improve existing workflows, and pursue efficiency
Impeccable attention to detail and ability to identify opportunities in data or workflows and document processes thoroughly
Ability to work under pressure and manage multiple priorities while maintaining attention to detail
Proficiency with Microsoft Office Suite
Knowledge of behavioral health care HCPCS/CPT coding preferred
Business acumen and strong financial skills preferred
Ability to maintain confidentiality of sensitive information preferred
Excellent verbal and written communication skills preferred
Strong interpersonal and relationship-building skills preferred
Ability to perform several tasks concurrently preferred
Ability to prioritize workload in a fast-paced environment preferred
Employees with potential access to protected health information must comply with HIPAA procedures and guidelines

Benefits

Comp & perks

Subsidized Health Insurance Coverage for Employee, Spouse, & Dependent(s)
100% Employer Paid Basic Life Insurance equal to 1x annual salary, up to $100,000
100% Employer Paid Employee Assistance Program
Voluntary Dental, Vision, Short-Term Disability, Supplemental Life & AD&D, Critical Illness, Accident, and Hospital Indemnity Insurance
Pre-tax Savings Accounts for all IRS-allowable medical and dependent care expenses
Generous Paid Time Off plan
Employee Referral Bonuses
401K Retirement Plan & Employer Match