Company Overview
Lifekind Health is dedicated to advancing modern medicine by providing expert diagnosis and treatment for orthopedic, complex, and persistent pain conditions. Our team combines decades of clinical experience with affiliations to renowned academic institutions, committed to improving patient outcomes through innovative approaches. We are seeking passionate professionals eager to make a meaningful difference in healthcare.
Position Summary
The Contract Management Specialist is responsible for negotiating and managing managed care contracts, maintaining contract management and reimbursement modeling systems, supporting provider education and health plan training initiatives, conducting market analyses to identify growth opportunities and forecast patient volume. This role serves as a key liaison between healthcare providers, health plans, and internal stakeholders to optimize payer relationships, reimbursement strategies, and network performance.
Responsibilities
Managed Care Contract Negotiation
- Lead negotiations for managed care agreements with commercial, government, and specialty health plans.
- Evaluate contract terms, reimbursement methodologies, and performance requirements to ensure favorable financial and operational outcomes.
- Collaborate with leadership, legal counsel, and operational teams to review contract language and mitigate organizational risk.
- Monitor contract renewal timelines and ensure timely execution of new and existing agreements.
- Maintain positive working relationships with payer representatives and key external stakeholders.
Contract Management Administration
- Administer and manage the organization's contract management system, ensuring contract accuracy, completeness, and compliance.
- Track contract terms, amendments, rate changes, terminations, and renewal schedules.
- Develop and maintain contract documentation, databases, and reporting tools.
- Ensure contract data integrity and support internal audits and compliance activities.
- Generate routine and ad hoc reports for leadership regarding contract status, performance, and opportunities.
Reimbursement Modeling and Financial Analysis
- Manage the contract modeling system to evaluate proposed reimbursement arrangements and financial impacts.
- Analyze payer fee schedules, reimbursement methodologies, and contract performance metrics.
- Develop financial models to support negotiation strategies and executive decision-making.
- Identify reimbursement variances and recommend corrective actions or renegotiation opportunities.
- Collaborate with finance and revenue cycle teams to validate reimbursement assumptions and outcomes.
Provider and Health Plan Training
- Coordinate and oversee provider and staff training related to health plan requirements, contract provisions, reimbursement methodologies, and payer updates.
- Develop educational materials and communication tools to improve provider understanding of payer policies and procedures.
- Serve as a subject matter expert regarding managed care contracts and payer processes.
- Support onboarding and ongoing education efforts for providers and operational teams.
Market Analysis and Strategic Planning
- Conduct market assessments to identify growth opportunities, payer trends, competitor activities, and network expansion opportunities.
- Analyze demographic, utilization, and payer mix data to forecast potential patient volume and revenue impacts.
- Prepare reports and presentations summarizing market findings and strategic recommendations.
- Support leadership in evaluating new contracting opportunities and service line expansions.
Required Qualifications
- Bachelor’s degree in healthcare administration, Business Administration, Finance, Public Health or related field, and/or a minimum of 5 - 8 years of experience in managed care contracting, healthcare reimbursement, provider relations, or healthcare finance.
- Experience negotiating payer contracts and analyzing reimbursement methodologies.
- Experience administering contract management systems and contract modeling software.
- Strong analytical, financial modeling, and problem-solving skills.
- Proficiency in Microsoft Office Suite, particularly Excel.
- Excellent written, verbal, and interpersonal communication skills.
Preferred Qualifications
- Experience in physician practice management, hospital systems, or healthcare payor strategy.
- Knowledge of Medicare, Medicaid, commercial payer contracting, and value-based care models.
- Experience with healthcare contract modeling and reimbursement analytics platforms.
Key Competencies
- Contract Negotiation
- Financial and Reimbursement Analysis
- Strategic Thinking
- Market Intelligence
- Relationship Management
- Data Analysis and Reporting
- Healthcare Industry Knowledge
- Communication and Presentation Skills
- Project Management
- Attention to Detail
Working Conditions
- Primarily work from home with occasional travel for payer meetings, provider education sessions, and industry events.
- Ability to manage multiple priorities and deadlines in a fast-paced healthcare environment.
Reporting Relationship
Reports to the Director of Payor Strategy.
Pay: $95,000.00 - $125,000.00 per year
Work Location: Remote
