Contract Specialist (Managed Care)

TL;DR

Contract Specialist (Managed Care): Implementing and maintaining managed care contracting strategies in a multi-state environment with an accent on payer negotiations and reimbursement analysis. Focus on maximizing net revenue through data-driven contract terms and resolving contractual issues with insurance carriers.

Location: Fully Remote (Global)

Company

hirify.global is a specialized revenue cycle management company with over 20 years of experience focusing on the Ambulatory Surgical Center (ASC) industry.

What you will do

• Negotiate and renegotiate managed care contracts with health plans, hospitals, IPAs, and government programs.
• Analyze contract terms and reimbursement structures using data models to develop actionable recommendations.
• Manage and maintain accurate files for pending and executed contracts, providing timely network updates to clients.
• Load and validate payer contract terms, rates, and fee schedules into client systems.
• Partner with clients to understand goals and tailor negotiation strategies to their specific challenges.
• Track regulatory updates and market trends that impact client reimbursement.

Requirements

• Experience negotiating externally with payers or acting as a liaison between payers and providers.
• Strong analytical skills to interpret complex data and synthesize it into client-ready insights.
• Proficiency in Excel and financial modeling tools.
• Excellent communication skills to explain data-driven recommendations to non-technical stakeholders.
• Bachelor's degree in Healthcare Administration, Business, Finance, or a related field.
• Familiarity with managed care contracts and reimbursement methodologies.

Culture & Benefits

• Fully remote work environment.
• Opportunity to work with a global team of experts.
• Fast-paced environment focused on innovation and exceeding expectations.
• Commitment to the social, financial, and physical health of coworkers and clients.