Manager, Payer Strategy and Revenue Intelligence
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Job Location:
Hourly Salary:
Experience Required:
Posted on:
4 hours ago
Vacancies:
1 Vacancy
Job Summary
This is a remote position.
Atlantic Health Strategies is seeking a Manager of Payer Strategy and Revenue Intelligence to lead payer contracting and credentialing strategy while overseeing payer-focused analytics and research. This role sits at the intersection of payer policy reimbursement strategy and data interpretation ensuring that contracting decisions and revenue assumptions are grounded in regulatory reality and defensible analytics.
The role is part-time initially approximately 10 hours per week with a defined path to full-time employment as payer volume and analytic scope expand. This is a high-trust role with meaningful autonomy and direct exposure to leadership.
Core responsibilities
Own and execute payer contracting and credentialing strategy across Medicaid and commercial payers including research sequencing and prioritization.
Serve as the internal subject-matter expert on payer policies reimbursement methodologies fee schedules modifiers and coverage rules relevant to behavioral health and substance use disorder services.
Conduct deep regulatory and payer research including Medicaid state plans managed care organization policies and commercial payer manuals translating findings into actionable guidance.
Supervise and guide the BI and data analytics function to ensure metrics dashboards and analyses accurately reflect payer rules and reimbursement realities.
Partner with leadership on payer mix strategy revenue integrity risk assessment and market entry decisions.
Support payer relations efforts by preparing analyses documentation and strategic positioning for payer interactions audits and negotiations.
Develop and maintain internal payer intelligence tools including reimbursement matrices payer summaries and contracting playbooks.
Requirements
Demonstrated experience in payer contracting credentialing reimbursement analysis or payer policy research within healthcare.
Strong independent research capability with the ability to interpret complex regulatory and payer documentation without reliance on templates or prior summaries.
Analytical judgment sufficient to challenge data outputs identify inconsistencies and flag unsupported revenue assumptions.
Working knowledge of Medicaid managed care and commercial payer contracting structures.
Clear written and verbal communication skills particularly when translating complex payer information for leadership and clients.
Comfort operating in a consulting or advisory environment with shifting priorities.
Benefits
Required Skills:
Required Qualifications (non-negotiable) Demonstrated experience in payer contracting credentialing reimbursement analysis or payer policy research within healthcare. Strong independent research capability with the ability to interpret complex regulatory and payer documentation without reliance on templates or prior summaries. Analytical judgment sufficient to challenge data outputs identify inconsistencies and flag unsupported revenue assumptions. Working knowledge of Medicaid managed care and commercial payer contracting structures. Clear written and verbal communication skills particularly when translating complex payer information for leadership and clients. Comfort operating in a consulting or advisory environment with shifting priorities.
Required Education:
Masters degree from an accredited university and at least 2 years in SUD Leadership.
Company Industry
IT Services and IT Consulting
Key Skills
- ASC 606
- Hotel Experience
- Hospitality Experience
- GAAP
- Accounting
- Revenue Management
- Pricing
- Analysis Skills
- Salesforce
- SOX
- ERP Systems
- NetSuite
