Job Description
Payor Contract Specialist COMPANY DESCRIPTION Unio Health Partners (UHP) is a highly differentiated physician practice management platform with the goal of transforming care delivery across the Western United States. UHP partners with leading physician practices, creating a cohesive, quality-oriented clinical culture and facilitating best practice sharing across the platform. Our affiliated practices gain access to a broader suite of services, providing a meaningful benefit to both physicians and patients. UHP's best-in-class clinical program covers three sub-specialties (urology, gastroenterology, and radiation oncology) and offers numerous ancillary services, including pathology lab, in-office dispensing, and chronic care management. We are led by a highly accomplished management team and provide a full suite of management services to its affiliated practices. UHP is currently affiliated with 182 providers consisting of 119 physicians and 63 advanced practice providers operating out of 54 locations across Southern, Central, and Northern California. POSITION SUMMARY The Payor Contract Specialist supports the Director, Payor Contracting in the administration, analysis, and maintenance of managed care agreements. This role is responsible for coordinating contract activities, maintaining accurate contract data, supporting payor communications, and assisting with issue resolution related to reimbursement and contract performance. The Specialist serves as a key liaison between Payor Contracting, Revenue Cycle Management (RCM), and operational teams to ensure contract terms are operationalized effectively and reimbursement aligns with contractual expectations. What you will be doing Supports the implementation, maintenance, and tracking of managed care contracts, including commercial and government payors. Maintains a comprehensive database of current, pending, and terminated contracts, including key terms, effective dates, and reimbursement structures. Assists in reviewing contract terms to identify reimbursement methodologies, carve-outs, and operational requirements. Performs basic financial and reimbursement analysis to support contract evaluations and identify variances. Coordinates with RCM to research and resolve reimbursement discrepancies, payment variances, and claim adjudication issues. Assists with provider credentialing and recredentialing processes as needed to support network participation. Researches new or existing payors to determine appropriate billing structure, product lines, and reimbursement expectations. What you will bring to the team Bachelor’s degree in Business, Healthcare Administration, or related field (preferred). Minimum of 3+ years of experience in managed care/payor contracting support, provider services, or revenue cycle within a healthcare setting. Working knowledge of managed care concepts, including reimbursement methodologies, fee schedules, and payor structures. Familiarity with Medicare, Medi-Cal, and commercial payor enrollment processes. Familiarity with provider credentialing processes (preferred). Understanding of healthcare regulatory requirements related to contracting and reimbursement. Experience working with multi-specialty physician groups or similar healthcare organizations (preferred). Ability to interpret contracts and translate terms into operational guidance. What we can offer you Competitive Salary and Health Benefits (Medical, Dental, Vision) Generous time off (start accruing on your first day - no waiting period) Paid Holidays 401(k) Company Discounts Collaborative work environment - we want our employees to have a say in how we run our office Employee Recognition Compensation is depending on a number of factors including a candidate’s qualifications, skills, competencies, or experience that may fall outside of the range shown