Managed Care Contract Specialist - Northwest Talent Solutions LLC

Northwest Talent Solutions is a leading Technology, Finance, and Healthcare staffing/recruiting and HR/DEI consulting firm partnering with outstanding clients within the private industry and public sector. Currently, we are partnered with a preferred healthcare provider in Houston seeking a highly talented Managed Care Contract Specialist to drive contract optimization and revenue performance.

Job Summary: 

Join a premier healthcare organization where you'll play a pivotal role in optimizing managed care contracts and driving revenue performance through sophisticated contract modeling and analysis. You'll serve as a key liaison between payers and internal stakeholders, ensuring optimal reimbursement strategies and contract compliance.

What Sets Our Client Apart:

• Competitive compensation range
• Comprehensive benefits package including medical, dental, vision, and life insurance
• 401(k) with company matching
• Flexible schedule options
• Investment in your growth through EPIC certification training
• Collaborative, fast-paced environment focused on excellence
• Career advancement opportunities in healthcare administration

Key Duties & Responsibilities:

• Drive contract modeling initiatives using Payment Integrity Compass (PIC) or Epic to optimize revenue performance
• Lead negotiations with third-party payers to secure favorable terms and rates
• Develop and implement strategic reimbursement models that align with organizational goals
• Partner with cross-functional teams to ensure accurate contract setup and maintenance
• Analyze complex healthcare insurance plans to identify optimization opportunities
• Create detailed financial models and forecasts using advanced Excel functions

Qualifications:

• Demonstrated success in hospital contract modeling and third-party payer negotiations
• Strong foundation in health insurance plans and reimbursement methodologies
• Experience with Payment Integrity Compass or Epic systems
• Advanced Excel skills including pivot tables and vlookup functions
• Bachelor's degree in Business Administration, Finance, or related field preferred
• Background in healthcare revenue cycle management

Applicant Insights:

• Share an example of how you've improved contract performance through analysis and modeling
• Describe your approach to stakeholder management when implementing new contract terms
• What strategies do you employ to stay current with healthcare reimbursement trends?

For confidential, immediate consideration, please apply with a formal copy of your resume along with your applicant insights and salary expectations.

Scale Beyond the Talent Bar
https://nwtalentsolutions.com/