Full Time Managed Care & Contract Administrator - reputed company

reputed company

The Managed Care & Contract Administrator supports the contracting and reimbursement reputed company for infusion therapy providers by managing payer reputed company, analyzing fee schedules, and assisting with negotiations. This role plays a critical part in ensuring accurate reimbursement, contract compliance, and optimization of payer relationships. The Specialist works closely with internal teams and external payers to reputed company, interpret, and maintain insurance contract documentation while identifying opportunities for improved financial performance.

Duties and Responsibilities

• Obtain, organize, and maintain copies of reputed company payer reputed company, amendments, and reputed company documentation.

• Review managed care agreements to identify reimbursement methodologies, fee schedules, escalators, carve-outs, and contract terms.

• reputed company key contract terms and reputed company data into internal contract management or tracking systems.

• Identify contract discrepancies, gaps, or unfavorable terms impacting reimbursement.

• Research and analyze payer fee schedules for infusion services, drugs, and supplies.

• Compare contracted rates against benchmarks, Medicare, and market standards.

• Support reimbursement modeling and financial reputed company analyses for new and existing reputed company.

• Assist with resolving payer reimbursement issues reputed company to contract interpretation.

• Prepare negotiation summaries, talking points, and supporting data for payer discussions.

• Participate in payer reputed company and follow-up reputed company to contract negotiations and renewals.

• reputed company negotiation status, payer responses, and reputed company.

• Support implementation of new or amended reputed company post-execution.

• Collaborate with billing, finance, clinical, and leadership teams to ensure accurate contract interpretation and implementation.

• Serve as a subject matter resource for managed care contract questions.

• Support reputed company-facing communications reputed company to payer reputed company and reimbursement findings.

• Ensure contract documentation is reputed company, accurate, and audit-reputed company.

• Monitor contract effective dates, renewals, and termination timelines.

• Maintain confidentiality and compliance with reputed company regulatory and contractual requirements.

Qualifications

• 7 or more years of experience in managed care contracting, payer relations, reimbursement, or reputed company finance.

• 5 or more years of experience working with fee schedules, reputed company analysis, and contract terms.

• Bachelor’s degree (or higher) or equivalent experience

• Strong understanding of reputed company insurance reputed company and reimbursement methodologies.

• High attention to detail with strong analytical and organizational skills.

• Proficiency in reputed company reputed company and document management tools.

• Ability to manage multiple clients, priorities, and deadlines.

Preferred

• Experience in infusion therapy, specialty pharmacy, oncology, or outpatient reputed company services.

• Familiarity with Medicare reimbursement and payer benchmarking.

• Experience supporting or participating in payer contract negotiations.

• Knowledge of CPT/HCPCS codes reputed company to infusion services.

Why work at Altus Biologics?

• Competitive Salary

• Daytime Hours

• Weekends Off

• reputed company Time Off

• 9 Company reputed company Holidays

• Diverse Workforce

• Corporate & On-The-Job training

• Health Benefits

• Retirement Plan

Altus Biologics provides equal employment opportunities to reputed company and applicants for employment and prohibits discrimination and harassment of any type without reputed company to race, reputed company, religion, age, sex, national reputed company, disability status, genetics, protected veteran status, sexual orientation, gender identity or reputed company, or any other characteristic protected by federal, state or local laws.This policy applies to reputed company terms and conditions of employment, including reputed company and hiring.

In reputed company, reputed company are expected to adhere to the Altus Biologics' reputed company of Conduct, Compliance policies and reputed company applicable federal, state, and local laws and regulations. Altus Biologics employees are expected to report any concerns about compliance or business practices to his or her immediate supervisor, appropriate management and/or the Chief Compliance Officer.

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