Contracts Manager

Job not on LinkedIn

🔥 14 hours ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Integrated Home Care Services, Inc.

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2015

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

Integrated Home Care Services, Inc. is an integrated home care benefits manager that coordinates and manages value-based home health services, durable medical equipment, and home infusion for patients and members on behalf of health plans and providers. It provides network development and credentialing, utilization management, claims adjudication, analytics, and a technology-enabled platform for referrals, real-time documentation, and 24/7 access to services, aiming to reduce costs, improve outcomes, and streamline administration for payers, providers, and patients.

📋 Description

• Oversee payer contract management activities within the Revenue Cycle Management department for home health and durable medical equipment services • Serve as the subject matter expert for payer reimbursement terms, contract interpretation, fee schedules, and operational requirements affecting billing and collections • Work with payers, revenue cycle leadership, compliance, credentialing, billing operations, and IT/system teams to translate contract terms into workflows and system configurations • Supervise a Contracts Specialist responsible for loading payer pricing, fee schedules, and contractual requirements into company systems and electronic networks • Review, analyze, and maintain payer contracts for home health and DME services • Interpret reimbursement methodologies, fee schedules, billing rules, authorization requirements, and payer-specific compliance obligations • Identify operational impacts of payer contract terms and communicate requirements to relevant departments • Monitor contract performance and reimbursement trends to identify discrepancies, underpayments, and revenue leakage opportunities • Collaborate on contract renewals, amendments, and payer negotiations by providing operational and financial insights • Maintain a centralized repository of payer contracts and related documentation • Establish and document payer requirements for implementation in company systems, ENS platforms, and billing workflows • Ensure payer-specific pricing, billing edits, authorization rules, and reimbursement requirements are accurately configured and maintained • Partner with IT, billing, and operational teams to validate system setup and resolve configuration issues affecting claims or reimbursement • Oversee testing and validation for payer updates, fee schedule changes, and system enhancements • Review and approve fee schedule uploads and payer configuration updates • Provide training, guidance, and performance management for direct reports • Develop and maintain standard operating procedures for payer contract implementation and maintenance • Ensure contract requirements comply with federal, state, and payer regulations • Support billing, collections, intake, and operational teams with contract interpretation and payer requirements • Assist with audits, appeals, and reimbursement investigations • Support continuous improvement initiatives focused on reimbursement accuracy • Perform all other related duties as assigned

🎯 Requirements

• Bachelor’s degree in Healthcare Administration, Business, Finance, or related field preferred • Minimum of 5 years of experience in healthcare revenue cycle, managed care contracting, payer relations, or DME/home health reimbursement • Strong understanding of home health and DME payer reimbursement methodologies, billing requirements, and revenue cycle operations • Experience interpreting managed care contracts and translating contract terms into operational requirements • Prior experience managing or supervising staff preferred • Knowledge of Medicare, Medicaid, commercial insurance, and managed care payer structures • Experience with healthcare billing systems, fee schedule management, and payer configuration processes • Strong analytical, organizational, and problem-solving skills • Excellent communication and cross-functional collaboration abilities • Comprehensive knowledge of managed care industry and product administration/implementation • IHCS is an equal opportunity employer committed to diversity and inclusion

🏖️ Benefits

• Medical, Vision, Dental, Short- and Long-term insurance • 6+ Days of Holidays Pay • 17 days of PTO • Employer paid life insurance • 401K with employer contribution • Wellness program with reward incentives • Employee recognition and reward programs • Comprehensive paid training program