Managed Care Contracting Manager

Location: Remote, USA

Salary: $95,000–$105,000 per year

Company

Healthcare services organization supporting home health, hospice, home care, and senior living operations across the United States through a centralized Service Center.

What you will do

• Develop and negotiate managed care contracts, reimbursement rates, amendments, and contract terms with payers and healthcare organizations.
• Analyze costs, rates, margins, contract risks, and financial advantages with Legal and Finance partners.
• Build and maintain managed care relationships while supporting new locations, services, contract updates, and terminations.
• Monitor industry and market changes to identify opportunities to protect and increase managed care revenue.
• Support denials, appeals, high-level claims issues, and timely collection of amounts due.
• Train and advise operational leaders, accounts receivable, intake, case management, and Service Center personnel.

Requirements

• At least 5 years of experience in managed care contracting with a payer or provider organization.
• Bachelor’s degree in business administration, management, or healthcare administration preferred.
• Knowledge of Medicare Advantage, Commercial, Managed Medicaid, ACOs, and value-based purchasing strategies.
• Knowledge of payer contract language, negotiated rate methodology, contract compliance, and financial analysis.
• Strong analytical, problem-solving, communication, critical thinking, prioritization, and attention-to-detail skills.
• Knowledge of HIPAA, CPT-4, HCPCS, revenue and ICD coding; willingness to travel.

Nice to have

• Knowledge of home health, hospice, private duty, or assisted living operations.
• Smartsheet experience.

Culture & Benefits

• Remote work within the USA.
• Support from centralized clinical, legal, compliance, risk management, HR, training, accounting, and IT resources.
• Culture built around accountability, learning, ownership, collaboration, and intelligent risk taking.
• Work with independently operated healthcare and senior living organizations.