Meetmarvin
Head of Payer Relationships Strategy
Los Angeles · Director · Full-time
Sponsorship not specifiedDetected 6 days ago
Business DevelopmentNegotiationFinancial AnalysisProcess ImprovementContract ManagementAR/VREHR/EMRICD-10LeadershipCommunicationCollaborationPlain LanguageFinancial Reporting
About the role
- The Head of Payer Relationships Strategy is a senior leader responsible for driving Marvin's payer strategy, contract performance, fee schedule management, and provider credentialing function.
- This role serves as the primary owner of all payer relationships and is the internal expert on how Marvin gets paid.
Responsibilities
- Own the full lifecycle of all payer contracts: negotiation, execution, renewal, and ongoing performance monitoring
- identify underpayment gaps and drive renegotiation to improve rates
- Maintain and update the practice's chargemaster and fee schedules in the EHR/practice management system (AdvancedMD)
- maintain direct, active relationships and know who to call to get things done
- Maintain and update the practice's chargemaster and fee schedules in the EHR/practice management system (AdvancedMD); ensure rates are accurate and current across all payers and service lines
- Serve as the primary point of contact for all payer representatives; maintain direct, active relationships and know who to call to get things done
- Own fee schedule management end-to-end: negotiation, loading, maintenance, and reconciliation
- Partner with Finance on chargemaster strategy to ensure billed charges reflect the appropriate markup above contracted rates
- Oversee the credentialing function with a dedicated credentialing team member handling day-to-day execution; own the standards, timelines, and outcomes
- Coordinate credentialing timelines with recruiting, onboarding, and partner launch schedules to prevent credentialing gaps from becoming billing gaps
Requirements
- Comfort engaging payers directly - including making calls, writing appeals, and attending payer meetings
- Master's degree (MBA, MHA, or related)
- Experience with denial analytics platforms and RCM automation tools
- EHR/billing platform proficiency (AdvancedMD)
- Bachelor's degree in Healthcare Administration, Finance, Business, or related field
- 7+ years of progressive RCM experience in healthcare, with at least 3 years in a leadership role
- Deep, hands-on experience in behavioral health payer contracting, fee schedule management, and payer relations
- Demonstrated track record of negotiating payer contracts and improving reimbursement rates
- Direct ownership of provider credentialing and payer enrollment processes
- Strong command of CPT, HCPCS, and ICD-10 coding in a behavioral health context
Nice to have
- Proficiency with EHR/practice management systems (AdvancedMD preferred) and clearinghouses
Skills
- Ensure fee schedules are correctly loaded in AdvancedMD for every payer and updated promptly when contracts change
- Audit reimbursements against contracted rates to identify systematic underpayments; initiate recovery and corrective action
- Track fee schedule performance across payers and present findings and recommendations to executive leadership
- Personally step in on complex enrollment issues, payer rejections, or credentialing disputes that require escalation
Compensation
- Conduct annual fee schedule reviews in partnership with Finance to ensure contracted rates remain strategically aligned with the cost of care
Benefits
- Analyze payer fee schedules and reimbursement rates across all contracts; identify underpayment gaps and drive renegotiation to improve rates
- Ensure compliance with payer policies, mental health parity laws, and applicable state and federal billing regulations
- Serve as the internal subject matter expert on behavioral health reimbursement, payer policy, and revenue cycle best practices
- Marvin Behavioral Health | Full-Time | Remote
Apply directly at Meetmarvin →Create a free account for alerts like thisView Meetmarvin immigration profile
This listing is sourced directly from Meetmarvin's careers page and normalized into a canonical job model.