Job Opportunities in United States


November 7, 2024

Northwest Talent Solutions LLC

Houston

FULL TIME


Managed Care Contract Specialist

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/

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