Payor Contract Management Coordinator

JOB SUMMARY:

The Payor Contract Management Coordinator for AVP SEES is responsible for managing the full lifecycle of payor contracting for specialty providers. This role partners closely with the Director of RCM and VP of RCM to ensure payor agreements are strategically negotiated, data-driven, and aligned with organizational reimbursement goals. The Contract Manager independently leads payor communications and negotiations, with executive involvement primarily limited to final review and approval of agreements.

This role does not have direct people management responsibilities; however, it requires a high level of expertise, autonomy, and influence across internal and external stakeholders.

ESSENTIAL FUNCTIONS/ KEY RESPONSIBILITIES

• Lead end-to-end payor contracting activities for specialty providers, including initiation, analysis, negotiation, amendment, and renewal of agreements.
• Serve as the primary point of contact with payor representatives, independently managing communications and negotiations.
• Develop and analyze detailed reimbursement models using historical and proposed rates to assess financial impact and overall percentage increases.
• Create and maintain reports analyzing top CPT code volume, utilization trends, and reimbursement performance.
• Research and evaluate market data across regions to benchmark CPT reimbursement rates against comparable specialty providers and ensure competitive or above-market positioning.
• Partner with RCM, Finance, Operations, and Clinical leaders to align contracting strategies with organizational growth and revenue objectives.
• Prepare executive-ready summaries and recommendations for contract approvals, highlighting financial impact, risks, and opportunities.
• Ensure contracts comply with regulatory, legal, and organizational standards in collaboration with Legal and Compliance partners.
• Monitor contract performance post-execution and identify opportunities for optimization, renegotiation, or remediation.
• Maintain accurate contract documentation and tracking, including key terms, rates, renewal timelines, and payor obligations.

REQUIRED QUALIFICATIONS:

• Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field, or equivalent experience.
• Minimum of 3 years of experience in payor contracting, with strong preference for specialty provider or hospital-based specialty experience.
• Demonstrated experience independently negotiating payor contracts and managing complex payor relationships.
• Advanced analytical skills, including the ability to model reimbursement scenarios using CPT-level data.
• Strong understanding of reimbursement methodologies, payor contracting structures, and healthcare revenue cycle operations.
• Excellent written and verbal communication skills, with the ability to influence and negotiate effectively

PREFERRED QUALIFICATIONS:

• Experience contracting for specialty or emergency services providers.
• Advanced proficiency in Excel and contract modeling tools.
• Familiarity with market benchmarking tools and payor rate databases.
• Experience partnering with executive leadership on contracting strategy.

KEY COMPETENCIES:

• Strategic thinking and financial acumen
• Negotiation and relationship management
• Data-driven decision-making
• High degree of autonomy and accountability
• Attention to detail and strong organizational skills