Managed Care Contract Specialist
Are you an accomplished professional seeking a dynamic role where you can apply your expertise in managed care contracting? We are looking for a Managed Care Contract Specialist to join our team. This position presents an exciting opportunity to work in a collaborative and fast-paced environment where efficiency and expert knowledge can drive success.
Core Responsibilities
- Build, load, test, and maintain hospital third-party payer contracts in the contract modeling system.
- Analyze data to support contract adjustments for maximizing reimbursement during negotiations.
- Participate in third-party payer negotiation discussions, providing rate modeling and analysis.
- Load and maintain hospital contract terms in internal databases for user and vendor access.
- Conduct prospective modeling of contracts, rate structures, and reimbursement scenarios.
- Analyze the financial impact of government and commercial fee schedule changes.
- Generate standard and ad-hoc reports to aid decision-making on reimbursement impacts.
- Support Managed Care Contract Administrators in identifying risks and opportunities in payer reimbursement proposals.
- Serve as a Subject Matter Expert (SME) for facility and professional contract reimbursement.
- Collaborate with internal teams (Revenue Cycle, Finance) and external vendors to resolve contract discrepancies.
- Initiate process improvement projects related to third-party payer reimbursement and internal operations.
- Ensure compliance with policies and standards, maintaining safety and effective resource management.
- Promote professional growth through continuing education and mentoring less experienced staff.
Essential Skills and Expertise for Managed Care
- Bachelor’s degree in Business Administration, Finance, or Accounting preferred.
- Complete EPIC application certification within the first 90 days of employment.
- 3 years of hospital contract modeling experience (preferably in PIC or Epic).
- Proficiency in Excel (pivot tables, v-lookup).
- Strong analytical, communication, and organizational skills.
- Ability to work independently and as part of a team in a fast-paced environment.
What We Offer in a Managed Care Role
- Competitive salary and a comprehensive benefits package.
- Medical, Dental, Vision Insurance, and 401K + Match.
- Opportunities for education, training, and career development.
- Work alongside a dedicated team committed to patient care.
- Access to employee assistance programs focusing on mental, physical, and financial wellness.
- A variety of additional benefits and perks.
Why Join Our Managed Care Team
Becoming a part of our team means joining a forward-thinking organisation committed to innovation and professional excellence. You will have the chance to contribute significantly to our mission, working alongside talented professionals who share your passion for managed care. We embrace a culture that values diverse perspectives and encourages continuous learning.
Application Process for Managed Care Contract Specialist
If you are a results-oriented professional ready to take the next step in your career, we encourage you to apply. Click the 'Apply Now' button to submit your CV along with a cover letter highlighting your experience in managed care contract negotiation and management. We look forward to reviewing your application and discussing how you can contribute to our team.
- Department
- Healthcare
- Locations
- Houston, TX, USA
About Salve.Inno Consulting
Bringing a personalized approach to connecting exceptional talent with unique opportunities. Specializing in recruitment for diverse roles, leveraging extensive experience and innovative strategies to find the perfect match for any business needs. Collaboration builds a stronger, more successful future – one strategic hire at a time.
Managed Care Contract Specialist
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