Contract Specialist, Managed Care - Remote

Overview

The Contract Specialist is responsible for implementing and maintaining nimble’s managed care contracting strategy in a multi-state environment, and we are looking for candidates to join the Managed Care Department who are eager to learn in a fast-paced environment!

In Short

• Manage and maintain accurate files for each pending and executed managed care contract; provide timely network updates to clients
• Serve as the external negotiator with payers on behalf of healthcare facilities and individual providers
• Analyze contract terms, reimbursement structures, and financial impact using data models and payer data
• Develop clear, actionable recommendations based on your analysis and present findings directly to the provider client
• Partner closely with clients to understand their goals and challenges
• Assist in resolving billing or contractual issues with insurance carriers
• Evaluate, negotiate, and renegotiate managed care contracts with health plans and other payers
• Load and validate payer contract terms, rates, and fee schedules into client systems
• Ensure organized documentation and version control for all contract files
• Track and interpret regulatory updates and market trends affecting client reimbursement

Requirements

• Strong analytical and critical thinking skills
• Demonstrated experience negotiating with payers
• Excellent communication and presentation skills
• Highly organized and detail-oriented
• Familiarity with managed care contracts and reimbursement methodologies
• Proficiency in Excel and financial modeling tools
• Bachelor's degree in Healthcare Administration, Business, Finance, or a related field preferred

Benefits

• Work in a fast-paced and innovative environment
• Be part of a team managing over $10 billion in net revenue
• Opportunity for professional growth and development
• Collaborate with experts in the field
• Contribute to improving healthcare outcomes