Payor Relations Manager
12 days ago
Costa Mesa
Job Description Position Summary: The Payor Relations Manager serves as the primary liaison between Agile and external Managed Provider Networks (MPNs), Third Party Administrators (TPAs), and insurance payers. This role is responsible for building and maintaining strong partnerships, ensuring operational alignment, streamlining credentialing and onboarding processes, and resolving escalations to protect service delivery and market reputation. The Manager collaborates cross-functionally with Sales, Operations, and Clinical Leadership to align strategies with partner expectations, support revenue growth, and improve overall customer satisfaction. Responsibilities: • Develop and maintain productive relationships with key TPAs, MPNs, and payer partners, acting as Agile’s ambassador to external networks., • Coordinate protocol setup in EMRs, portals, and credentialing processes to ensure seamless client access and satisfaction., • Monitor account performance, identify trends, and resolve operational issues in partnership with internal teams., • Oversee escalations across care delivery, billing, and service coordination, ensuring timely and professional resolution., • Serve as an internal cross-functional liaison, working with Sales, Operations, and Clinic teams to align strategies with partner needs., • Track performance metrics, service outcomes, and account growth to inform process improvements and guide negotiations., • Support bids, RFPs, contract negotiations, and renewals involving TPAs and MPNs., • Collaborate with Marketing to ensure consistent messaging and materials for network partners., • Maintain up-to-date knowledge of occupational medicine industry standards, payer requirements, and regulatory changes affecting MPN/TPA relationships., • Identify and establish strong relationships with Nurse Triage companies to further elevate customer experience., • Represent Agile at industry events, trade shows, and community engagements to strengthen brand visibility and client relationships, • Performs other job-related duties as assigned. Required: • Bachelor’s degree in Business, Healthcare Administration, or a related field., • 3–5 years of experience managing TPA, network, or payer relationships—preferably within occupational medicine or a related healthcare service., • Strong organizational, communication, and stakeholder management skills., • Proven ability to work cross-departmentally and manage complex relationship dynamics., • Proficiency in CRM systems, EMR platforms, and Microsoft Office Suite., • Relationship-builder who fosters trust and credibility with MPN, TPA, and payer partners., • Detail-oriented professional who ensures accuracy in credentialing, onboarding, and network management processes., • Proactive problem solver who anticipates issues and implements solutions before they escalate., • Process-driven leader who can streamline workflows for efficiency and consistency., • Strong communicator and negotiator who can influence stakeholders at all levels., • Collaborative team player who works effectively across sales, operations, and clinical teams., • Results-focused with the ability to measure success through partner satisfaction, retention, and revenue growth. Benefits: • Competitive salary, • Comprehensive benefits package, • Optimal work life balance with no nights, no weekends, and no holidays requirement to work, • Opportunity to work in a fast-paced and dynamic environment, • Be part of a team that is passionate about making a difference Salary: Starting compensation range $75,000.00 - $85,000.00 annually. Exact compensation may vary based on skills, experience, and location. Why You Should Join Our Team Agile Occupational Medicine is a leading occupational medicine group with a network of 24 clinics and one surgery center dedicated to providing comprehensive healthcare services to businesses and their employees across California and Yuma, Arizona. We specialize in ensuring the health and well-being of workers through a range of medical services, including injury care (workers’ compensation), physical examinations (employer services), and commercial (urgent care) We are a rapidly growing company with a fun and collaborative work environment. We are passionate about disrupting the world of occupational medicine, and we are committed to providing our customers and patients with the best possible experience. We offer our employees competitive salaries, commission, and benefits, and we give them the opportunity to make a real impact on the business. Agile Occupational Medicine is an Equal Opportunity Employer. Agile does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided upon qualifications, merit, and business need.