St Louis, Missouri, USA
3 days ago
Managed Care Contracting and Provider Relations Manager
Overview A tech-enabled, multidisciplinary healthcare organization, EmpowerMe Wellness is on a mission to improve the lives of seniors. EmpowerMe enriches senior living communities nationwide through our fully integrated healthcare model, which features on-site care coordination, therapy, and pharmacy services. Headquartered in St. Louis, Missouri, our 3,500+ team members drive positive outcomes and build healthier, happier tomorrows for older adults. To learn more, visit empowerme.com today. Responsibilities As the Managed Care Contracting and Provider Relations Manager, you will be responsible for expanding and optimizing our national payor network strategy. This high-impact leadership role is focused on securing new payor agreements, re-negotiating existing contracts, and fostering strong relationships with managed care organizations to ensure timely patient access to our services. Leveraging your established industry connections and deep knowledge of managed care contracting, you will proactively identify opportunities, overcome network entry barriers, and create value-driven partnerships that highlight the benefits we deliver to payors and their members. This position is ideal for a strategic, results-driven individual with strong negotiation skills and national experience navigating complex payor landscapes. Your essential duties include the following: Lead all aspects of managed care contract negotiations, including new agreements, amendments, and renewals with commercial, Medicare Advantage, and other managed care payors Develop and execute a comprehensive contracting strategy that aligns with organizational growth goals and enhances patient access to in-network services Utilize established payor relationships to accelerate network entry opportunities, reducing reliance on standard Letter of Interest (LOI) processes Act as the primary liaison with payors, maintaining positive relationships and resolving contract-related issues promptly Collaborate with internal stakeholders (Operations, Finance, Revenue Cycle, Legal) to ensure contracts are financially sound, compliant, and operationally feasible Monitor market trends, competitive activity, and regulatory changes impacting managed care contracting and reimbursement Partner with leadership to identify and pursue new payor partnerships that expand our national footprint Track, analyze, and report on contract performance and financial outcomes, identifying opportunities for improvement or renegotiation Represent the organization professionally in all interactions with external payor representatives, demonstrating our value proposition and commitment to member outcomes Perform other duties as assigned that are consistent with qualifications, professional practices, and ethical standards Tasks and responsibilities are subject to change at your supervisor’s discretion Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions Qualifications Minimum of 3 years of managed care contracting experience with proven success negotiating payor agreements. At least 5 years in a healthcare network management, payor relations, or provider contracting role is strongly preferred Demonstrated success building relationships and influencing decision-makers within major national payor organizations In-depth understanding of managed care principles, reimbursement methodologies, and commercial and Medicare Advantage markets Strong negotiation skills with the ability to develop creative contracting solutions and drive favorable outcomes Proven ability to manage multiple high-priority projects simultaneously in a fast-paced environment Excellent communication, presentation, and interpersonal skills Self-motivated, strategic thinker with a solutions-oriented mindset Knowledge of revenue cycle processes and the impact of payer contracts on operational and financial outcomes is a plus Ability to handle sensitive information with discretion and professionalism Computer Skills: Proficiency in Microsoft Office applications (Outlook, Excel, Word, and PowerPoint). Experience with contract management systems, EMRs, and payer portals preferred. Work Environment & Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. An individual should possess the physical ability to lift/move 20lbs, maintain a stationary position, move freely, operate equipment, ascend/descend freely, position self to reach equipment above or below average standing height, and communicate with employees throughout the organization. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; sit; stoop; walk; use hands and fingers to handle or feel; and reach with hands and arms. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. This employer is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, the employer will provide reasonable accommodations to qualified individuals with disabilities and encourages prospective employees and incumbents to discuss potential accommodations with the employer.
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