Healthcare Payer Relations & ACO Manager

Job Description

Job Description

Healthcare Strategy Manager – ACO & Payer Relations

Location : Southfield, MI ( On-site )

Job Type : Full Time

At EPIC Health, we’re not just changing healthcare—we’re rebuilding it from the ground up. We believe that patient care should be smarter, faster, and more connected. That’s where you come in. As the Healthcare Strategy Manager – ACO & Payer Relations , you’ll play a key role in driving strategic initiatives, managing payer relationships, and optimizing Accountable Care Organization (ACO) performance.

If you know how to blend strategy with execution, navigate complex payer contracts, and thrive in a fast-paced, high-stakes environment—this is your chance to make a real impact.

What You’ll Do

You won’t just be sitting behind a desk—this role is all about action. You’ll be the strategic link between our care delivery teams and financial partners, helping to shape how EPIC Health delivers value-based care.

Value-Based Reimbursement Strategy

• Develop and implement strategies to maximize value-based reimbursement opportunities.
• Analyze financial and operational data to identify trends and areas for improvement.
• Collaborate with clinical and financial teams to align business strategy with value-based care goals.
• Create systems to track and enhance reimbursement performance across all payer contracts.

Payer Relations & Contract Negotiation

• Build and maintain strong relationships with insurance payers and healthcare partners.
• Negotiate and manage payer contracts to secure favorable terms and improve reimbursement rates.
• Act as the primary point of contact for all payer-related issues and performance reviews.
• Develop innovative contracting strategies that drive financial success without compromising care quality.

ACO (Accountable Care Organization) Management

• Lead the strategic management of ACO programs, including performance monitoring, reporting, and compliance.
• Develop and implement strategies that improve patient satisfaction and clinical outcomes while managing costs.
• Partner with clinical and administrative teams to ensure effective execution of ACO initiatives.

• Monitor ACO performance data and adjust strategies to optimize patient care and financial outcomes.

Data Analysis & Reporting

• Conduct detailed financial and operational analysis to assess performance and identify opportunities.
• Create actionable reports and recommendations for senior leadership.
• Use data insights to shape future strategies and forecast financial performance.

Regulatory Compliance

• Ensure compliance with federal, state, and local healthcare regulations.
• Develop policies and procedures to maintain regulatory compliance in payer contracting and ACO operations.
• Stay ahead of industry changes and proactively adjust strategies to align with new guidelines.

What You Bring

You know how to balance strategy with execution, and you’re not afraid to step up when the stakes are high.

Education

• Bachelor’s degree in Healthcare Administration, Business Administration, Finance, Health Law, or a related field required.
• Master’s degree preferred.

Experience

• 5+ years of experience in healthcare administration, payer relations, value-based reimbursement, or ACO management.
• Proven success in negotiating contracts and managing payer relationships.
• Experience with data analysis and financial reporting in a healthcare setting.
• Strong track record of managing projects across multiple teams and business units.

Skills & Competencies

• In-depth knowledge of value-based reimbursement models and ACO operations.
• Exceptional negotiation and communication skills.
• Proficiency in data analysis, financial modeling, and reporting tools.
• Strong problem-solving and critical-thinking abilities.
• Ability to manage multiple priorities and work effectively under pressure.
• Comprehensive understanding of healthcare regulations and compliance requirements.

Why EPIC Health?

We value our team members and back that up with benefits that matter:

• Competitive Salary: Your expertise and leadership deserve recognition.
• Comprehensive Benefits: Health, dental, vision, and more to support you and your family.
• Professional Growth: Access opportunities for continued education and career advancement.
• Collaborative Culture: Work with a team of passionate professionals dedicated to transforming healthcare.
• Impactful Work: Your work will directly influence patient care and healthcare delivery.

Ready to Drive Healthcare Innovation?

If you’re passionate about improving healthcare and know how to make value-based care work, we want to hear from you.

Apply today and take the next step in your career with EPIC Health.

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*Background checks are required for this role.