Payer Contract Manager

About Us

Circle Medical is the fastest-growing telemedicine provider in the US and has seen incredible growth of over 200% per year in each of the previous two years.

Circle Medical is a venture-backed Y-Combinator healthcare startup on a mission to bring quality, delightful primary care to everyone on the planet. Built by top-tier physicians, engineers, and designers, our medical practice and underlying technology have pioneered how people find and receive care.

Our focus on building directly for our patients and providers to address serious care accessibility issues has enabled us to grow over 3X year-over-year. We’re now using our most recent round of funding from WELL Health, backed by Sir Li Ka-shing, to continue building out our hybrid in-clinic and telemedicine model across all fifty states.

Join us in our mission to revolutionize healthcare delivery and improve the lives of patients everywhere.

More about us can be found on our website.

Description

If you are a dynamic healthcare professional with a passion for contract management and a commitment to driving results, we want to hear from you. We are looking for an experienced Manager of Payer Contracts to oversee the negotiation and management of contracts with Circle Medical’s healthcare payers. The ideal candidate will have a strong background in healthcare contract management, a deep understanding of payer reimbursement methodologies, and excellent negotiation skills. This position plays a crucial role in ensuring the financial success and operational efficiency of our healthcare organization. The Manager of Payer Contracts will report to the CFO in the interim.

• Lead the negotiation and execution of contracts with healthcare payers, ensuring favorable terms and reimbursement rates for Circle Medical.
• Develop and maintain strong relationships with payer organizations ensuring alignment with our strategic objectives.
• Analyze payer contracts and reimbursement methodologies to identify opportunities for optimization and improvement.
• Collaborate with internal stakeholders, including Finance, Legal, RCM, and Operations to ensure alignment on contract terms and compliance with regulatory requirements.
• Monitor payer performance against contractual obligations and key performance indicators, proactively addressing any issues or discrepancies.
• Stay informed about industry trends, regulatory changes, and emerging best practices in healthcare regulations, incorporating this knowledge into contract negotiations and strategy.
• Provide guidance and support to team members involved in contract management and negotiation processes.

• Experience in Healthcare Administration, Business Administration, Finance, or a related field.
• Minimum of 5 years of experience in healthcare contract management, with a focus on payer contracts.
• In-depth understanding of healthcare reimbursement methodologies and payer contract language.
• Proven track record of successfully negotiating contracts with healthcare payers, IPAs and Clinically Integrated Networks, achieving favorable outcomes for the organization.
• Strong analytical skills, with the ability to interpret complex contract terms and financial data.
• Excellent communication and interpersonal skills, with the ability to build relationships and influence stakeholders at all levels of the organization.
• Detail-oriented and highly organized, with the ability to manage multiple projects and priorities effectively.
• Knowledge of healthcare regulatory requirements and compliance standards.

• Certification in healthcare management or payer contract management is a plus.

Compensation

Circle Medical offers a competitive salary and benefits package, as well as opportunities for professional growth and development. In alignment with our values, Circle Medical has transparent salaries based on merit-based output levels, and our total rewards include equity options.

This is a full-time, salaried exempt position with an annual salary range of $94,880 - $152,460 dependent on location, plus generous vacation, full health benefits, and 401K with company matching.

Additional Benefits:

- Flexible vacation, eligibility after 90-days 

- 10 annual paid Holidays

- $500 annual education and development reimbursement 

- Medical, Dental, Vision benefits, Life & additional supplemental coverage options

- 401K + Company Matching Program

Circle Medical is an equal-opportunity employer and affirmatively seeks diversity in its workforce. Circle Medical recruits qualified applicants and advances in the employment of its employees without regard to race, color, religion, gender, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, ethnic or national origin, marital status, veteran status, or any other status protected by law.