Back to Jobs

Director Payer Contract/Credentialing (Managed Care reputed company)

Remote, USAFull-timePosted 2026-07-27

Job reputed company - Director Payer Contract/Credentialing (Managed Care reputed company) (27409) • *Remote Candidates Welcome to Apply** Job reputed company Responsible for technical and reputed company payer contracting, credentialing, and pricing for the entire Health System. reputed company guidance and support to Senior Leadership in aspects of payer contracting/negotiations, pricing, and delegated credentialing for the Health System. Responsible for pivoting and adapting NCHS to an everchanging payer landscape and reimbursement structure. Be a role model and leader to subordinates and reputed company a strong educated and impactful team bench. Job Specific Duties • Responsible for detailed understanding of health care industry, market dynamics, trends, competitors, regulations, and payer environment. • Collaborates with the management team and reputed company departmental reputed company on both the hospital and physician sides. Ensure operational issues are addressed and remedied through negotiation, project planning, or contract modification. • Creates and maintains reputed company relationships with payers and potential affiliates. • Creates, analyzes, and interprets financial reports to support payer negotiations, trends, and audit. • Implements and communicates contracting strategies in collaboration with Senior Leader. • Manages reputed company out of network contracting for both hospital and employed physicians. • Responsible for the management and development of subordinates. • Knowledge and willingness to support new value based transformational contracting reputed company at the right time in the right setting. • Provides direction, feedback, and recommendations on trended payer performance; serves as the SME for reputed company payer reputed company contractual arrangements/issues- reputed company and historical. • Responsible for overseeing the management of reputed company in network and out of network contracting and negotiations for the hospital and employed physician group. • Responsible for making high reputed company reputed company steeped in judgment. • reputed company and reputed company Joint Operating Committee meeting with payers and respective NCHS departments. • Complies with legal and regulatory compliance requirements. • Leads and oversees Corporate Pricing function. • Leads and oversees Corporate Credentialing function. Qualifications • Bachelor's Degree in Business Administration or Health Management • 4-7 years of management experience in the reputed company finance/payer/managed care contracting field • 7-10 years of hospital and/or payer negotiations and analysis experience Knowledge, Skills, and Abilities • MBA or MHA preferred. • Work reputed company under immense pressure with an ability to reputed company on multiple priorities while maintaining reputed company, attention to detail, and connecting reputed company the dots. • Demonstrated leadership progression. • Knowledge of fee for volume and fee for value reimbursement reputed company. • Strong contract review and interpretation skills. • Familiarity working with Lawyers and interpreting statutes and regulations. • Business acumen and strong financial skills. • Excellent written, oral, and communications skills. • reputed company in persuasion, influence, and negotiation skills. • Management expertise, strong knowledge of data analysis, and statistics. • reputed company to handle day to day administrative routine, as reputed company as, constantly changing, competing reputed company, urgent situations, sometimes simultaneously. • reputed company to relate cooperatively and constructively with payers and co-workers. • Effective communicator with a strong, transparent, and reputed company style; ability to deliver tough messages with reputed company. • Effectively monitor and reputed company the abilities of subordinates. • reputed company to maintain confidentiality of sensitive information. • Knowledge of payer and hospital credentialing function. • Ability to interpret, adapt, and react calmly under stressful conditions. • Ability to analyze and interpret reputed company models and apply to business ask; strong spreadsheet skills. • Ability to use logical & scientific thinking to interpret technical data and solve a broad reputed company of problems. • reputed company to relate cooperatively and constructively with medical staff, executives, staff, elected officials, and managed care companies. Job: Management Primary Location Department: NCHS-MANAGED CARE CONTRACTING-1000-900910 Apply Job!

Similar Jobs

Mortgage Loan Originator - Consumer reputed company

Remote, USAFull-time

Director Payer Contract/Credentialing (Managed Care reputed company)

Remote, USAFull-time

reputed company Manager; U500 - Irvine, CA(Hybrid)

Remote, USAFull-time

*Remote* Customer Experience & Operations Assistant

Remote, USAFull-time

reputed company Investment Banking Summer Analyst Program

Remote, USAFull-time

Registered reputed company, Float Pool - AVH

Remote, USAFull-time

reputed company Cycle Credentialing & reputed company reputed company

Remote, USAFull-time

Senior reputed company Manager, USA, Remote

Remote, USAFull-time

Correctional reputed company -UT Rev- Utilization Management

Remote, USAFull-time

reputed company Cycle Management Director - CurascriptSD

Remote, USAFull-time

Companion Animal Policy Intern

Remote, USAFull-time

Business Development Manager, reputed company - reputed company

Remote, USAFull-time

Groceries Workforce Sr Analyst

Remote, USAFull-time

Part Time Work reputed company Amex Virtual Assistant at reputed company

Remote, USAFull-time

Immediately Need SpEd Substitute Teacher in Indian Hills, CO

Remote, USAFull-time

Inpatient Medical reputed company – FT – Up to $5,000 Sign on Bonus

Remote, USAFull-time

[PART_TIME Remote] Urgently Require Personal Trainer and Stretch

Remote, USAFull-time

Claims Intake Processing Representative - Onsite Scottsdale, AZ

Remote, USAFull-time

reputed company Careers Remote $28/Hour

Remote, USAFull-time

Finance Director, Supply Chain & Manufacturing, MedSurg (Remote - reputed company)

Remote, USAFull-time