Payer Contracts Manager

Posted Yesterday
Be an Early Applicant
2 Locations
In-Office or Remote
150K-165K Annually
Senior level
Hospital Care
The Role
Manage the full lifecycle of payer, IPA, and medical group contracts, including evaluation, negotiation, implementation, renewal, and performance monitoring. Analyze reimbursement rates and financial terms, develop models, support underpayment and claims issue resolution, and translate contract requirements into operational workflows. Partner with Finance, Revenue Cycle, Legal, Operations, Credentialing, and Business Development while monitoring California managed care trends and supporting expansion into new markets and service lines.
Summary Generated by Built In

Company Overview

Infusion for Health is dedicated to providing exceptional infusion therapy experiences for patients with autoimmune disorders and complex chronic conditions. Our mission centers on delivering professional, compassionate, and patient-focused care in a welcoming environment, supported by a team of highly trained clinical and administrative professionals.

Job Summary

The Contracts Manager will support the full lifecycle of payer agreements, including contract evaluation, negotiation, implementation, maintenance, and performance monitoring. This individual will partner closely with Payer Strategy, Revenue Cycle, Finance, Legal, Operations, Credentialing, and Business Development to ensure contracts are financially sustainable, operationally executable, and aligned with Infusion for Health’s growth strategy.

This is a remote position based in California, with minimal travel required throughout the state.

Responsibilities

  • Manage the full lifecycle of payer, IPA, and medical group contracts, including initial review, negotiation, execution, implementation, renewal, amendment, and termination.
  • Develop and maintain productive relationships with California IPAs, medical groups, health plans, and other payer partners.
  • Evaluate reimbursement rates, fee schedules, contract language, and financial terms to assess the overall value and viability of agreements.
  • Negotiate reimbursement and contractual terms with commercial health plans, Medicare Advantage plans, Medicaid managed care organizations, IPAs, and delegated medical groups.
  • Review and interpret California IPA agreements, including provisions related to delegated risk, divisions of financial responsibility, authorization requirements, claims submission, reimbursement, and dispute resolution.
  • Develop contract analyses, reimbursement comparisons, and financial models to support negotiation strategies and leadership decisions.
  • Coordinate with Revenue Cycle, Finance, Operations, Credentialing, and other internal partners to ensure new and amended contracts are implemented accurately and on time.
  • Translate contract requirements into clear workflows, system configurations, and operational guidance for internal teams.
  • Maintain a centralized repository of payer and IPA contracts, amendments, fee schedules, renewal dates, notice requirements, and other key provisions.
  • Monitor contract performance and investigate discrepancies between contracted terms and actual reimbursement.
  • Support the resolution of issues involving underpayments, denials, authorization requirements, eligibility, claims routing, reimbursement, and contract interpretation.
  • Monitor California managed care and payer trends that could affect reimbursement, network participation, or the company’s growth strategy.
  • Support contracting activities related to new markets, new service lines, and new infusion center openings.
  • Create scalable contracting processes, tools, and reporting practices for a growing organization.

Qualifications:

  • Bachelor’s degree in healthcare administration, business, finance, or a related field required; advanced degree preferred.
  • Five or more years of experience in managed care contracting, payer relations, network development, reimbursement, or a related healthcare function.
  • Direct experience negotiating and managing contracts with California IPAs and delegated medical groups is required.
  • Established knowledge of California managed care landscape and common IPA contracting structures.
  • Strong understanding of delegated arrangements, divisions of financial responsibility, risk-based and fee-for-service reimbursement, authorization requirements, claims processes, and dispute-resolution provisions.
  • Experience negotiating and administering agreements with commercial and government-sponsored health plans.
  • Strong understanding of healthcare reimbursement methodologies, fee schedules, contract structures, and managed care terminology.
  • Strong project-management skills and the ability to manage multiple contracts, deadlines, and competing priorities.
  • Experience in infusion therapy, specialty pharmacy, ambulatory healthcare, or another specialty provider environment is strongly preferred.
  • Experience supporting payer contracting across multiple states is preferred.

Compensation:

  • Base Salary: $150,000 - $165,000

Why Join Us?

  • Be part of a pioneering healthcare company making a significant impact on patients' lives.
  • Work with a dynamic, supportive team that values your sales expertise and contributions.
  • Enjoy professional growth opportunities, a flexible work environment, and the ability to make a meaningful impact.

Join us as we strengthen our contractual foundation to better serve our patients through innovative partnerships and compliant procurement practice

Skills Required

  • Bachelor's degree in healthcare administration, business, finance, or a related field
  • Five or more years of experience in managed care contracting, payer relations, network development, reimbursement, or a related healthcare function
  • Direct experience negotiating and managing contracts with California IPAs and delegated medical groups
  • Knowledge of the California managed care landscape and common IPA contracting structures
  • Understanding of delegated arrangements, divisions of financial responsibility, risk-based and fee-for-service reimbursement, authorization requirements, claims processes, and dispute-resolution provisions
  • Experience negotiating and administering agreements with commercial and government-sponsored health plans
  • Understanding of healthcare reimbursement methodologies, fee schedules, contract structures, and managed care terminology
  • Strong project-management skills and ability to manage multiple contracts, deadlines, and competing priorities
  • Advanced degree
  • Experience in infusion therapy, specialty pharmacy, ambulatory healthcare, or another specialty provider environment
  • Experience supporting payer contracting across multiple states
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The Company
HQ: Brea, California
178 Employees
Year Founded: 2015

What We Do

At Infusion for Health, we are dedicated to delivering patient-centered infusion and injection therapy for individuals living with chronic and complex conditions. We are committed to clinical excellence, affordability, and an exceptional patient experience. By offering comfortable, private suites and flexible care options, including in-home treatment, we create a more convenient and supportive alternative to traditional infusion services. Our team partners closely with physicians and health plans to streamline the infusion process, improve efficiency, and ensure every patient receives personalized, safe, and seamless care. As we continue to expand, our mission remains the same: to elevate the standard of care through compassion, innovation, and a patient-first approach.

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