Payer Contracting & Reimbursement Negotiator

Full-Time | St. George, Utah | Vive Adolescent Care

Vive Adolescent Care is seeking an experienced, persistent and financially minded Payer Contracting & Reimbursement Negotiator to strengthen reimbursement for the behavioral health services we provide.

This is not a traditional billing or Utilization Review position.

We are looking for someone who understands how insurance companies reimburse healthcare providers and knows how to negotiate, follow up, escalates and close the loop when rates do not appropriately reflect the services being provided.

The right person will take ownership of our Single Case Agreement (SCA), out-of-network reimbursement and payer negotiation process from beginning to end.

• Negotiate Single Case Agreements and out-of-network reimbursement rates with commercial insurance payers.
• Initiate SCA negotiations during the authorization process rather than waiting until after services have been provided.
• Push back appropriately on network exceptions that do not establish acceptable reimbursement terms.
• Review proposed reimbursement against Vive's established rate expectations and historical payer performance.
• Renegotiate inadequate reimbursement and contract terms.
• Maintain active follow-up with payer representatives until agreements are finalized.
• Obtain and maintain written documentation of negotiated rates and terms.
• Track every active SCA, negotiation, payer contact, proposed rate and final outcome.
• Partner closely with Utilization Review, Admissions, Billing and leadership.
• Identify underpayments or discrepancies between negotiated terms and actual payment.
• Escalate unresolved payer issues appropriately.
• Assist with payer appeals and post-service negotiations when necessary.
• Identify recurring payer trends and opportunities for broader contracting conversations.
• Maintain a clear payer database including negotiated rates, contacts, historical outcomes and contracting opportunities.
• Provide leadership with regular reporting on negotiations, reimbursement improvement and outstanding financial risk.

You know what is happening with every active payer negotiation.

SCAs are pursued consistently and early.

Agreements are documented before they disappear into an email chain.

Payers receive consistent and persistent follow-up.

Vive understands what it expects to be paid before services are provided whenever possible.

Underpayments are identified and challenged.

Leadership can clearly see where revenue is being lost, recovered or improved.

And most importantly you don't consider a negotiation finished just because an email was sent. You follow it through to resolution.

• 3+ years of healthcare payer contracting, managed care contracting, SCA negotiation, reimbursement, provider relations or related experience preferred.
• Direct experience negotiating with commercial health plans strongly preferred.
• Hospital, behavioral health, residential treatment or facility reimbursement experience highly valued.
• Understanding of Single Case Agreements, out-of-network reimbursement and commercial insurance.
• Ability to read and understand reimbursement language, payer agreements, EOBs and payment terms.
• Strong financial and analytical skills.
• Excellent written and verbal negotiation skills.
• Exceptional follow-through and organization.
• Comfort making repeated calls, escalating issues and professionally pushing back when necessary.
• Ability to build productive relationships with payer representatives while still protecting the organization's financial interests.

$65,000–$68,000 annual base salary, depending on directly relevant experience.

This position is also eligible for a performance incentive of up to $15,000 annually based on measurable contracting and reimbursement outcomes.

Exceptional candidates with significant hospital/facility payer contracting experience may be considered above the posted base range.

Vive provides intensive behavioral health services to adolescents and families during some of their most difficult moments.

Strong payer relationships and appropriate reimbursement allow us to continue providing those services.

This role will have the opportunity to build a more sophisticated payer negotiation process, directly influence reimbursement strategy and demonstrate measurable financial impact across the organization.

We're looking for someone who enjoys finding the dollars that should be there—and isn't afraid to keep working until they are.