Managed Care Contracting Specialist

🔥 55 minutes ago

🏄 California, Illinois – Remote

🏄 California – Remote 🌽 Illinois – Remote

💵 $83.3k - $166.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Abbott

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1888

🏥 Healthcare

⚕️ Healthcare Insurance

🧬 Biotechnology

Healthcare • Healthcare Insurance • Biotechnology

Abbott is a global healthcare company committed to advancing medical technologies and improving lives around the world. It offers a broad range of leading products in diagnostics, medical devices, nutrition, and branded generic medicines. Abbott's innovations such as the FreeStyle Libre glucose monitoring systems and BinaxNOW rapid antigen tests are transforming diabetes management and COVID-19 response. Through its partnerships and initiatives, Abbott aims to foster health equity, improve access to healthcare, and address critical health challenges like malnutrition and infectious diseases. Abbott is also dedicated to sustainability and social responsibility, striving to make life-changing technologies accessible and affordable.

📋 Description

• Review, analyze, and renegotiate DME and IDTF contracts to align with organizational goals and market standards • Ensure agreements comply with federal, state, and payer regulations • Identify opportunities for cost savings and improved service delivery through contract optimization • Draft, review, and execute Letters of Agreement (LOAs) for special arrangements or exceptions • Resolve billing and payment issues with non-contracted providers • Monitor contract performance, reimbursement trends, and regulatory changes • Provide reporting and strategic insights to leadership • Manage provider relationships

🎯 Requirements

• Associate degree or equivalent, or 3+ years of experience in managed care, payer relations, or healthcare sales, preferably in DME or IDTF • Strong understanding of payer contracting, reimbursement methodologies, and healthcare regulations • Excellent negotiation, communication, and relationship-building skills • Proficiency in CRM and contract management systems • Ability to attend job-related courses and seminars as required • Ability to use office equipment relevant to job functions • Preferred: Experience working with Medicare Advantage, Medicaid MCOs, and commercial payers to obtain LOAs • Preferred: Familiarity with HCPCS coding and billing practices for DME and diagnostic services • Preferred: Ability to interpret and explain clinical documentation to payers

🏖️ Benefits

• Career development with an international company • Free medical coverage eligibility through the Health Investment Plan (HIP) PPO medical plan in the next calendar year • Retirement savings plan with a high employer contribution • Tuition reimbursement • Freedom 2 Save student debt program • FreeU education benefit toward a bachelor’s degree • Health and wellness benefits

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