Contract Specialist, Managed Care

🔥 1 minute ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 11%

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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nimble solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💼 Consulting

📦 Logistics

🛡️ Insurance

Consulting • Logistics • Insurance

nimble solutions is a company focused on innovative online solutions, offering services related to payment processing, account management, and invoicing. It leverages web-based technologies to provide efficient and user-friendly platforms for managing financial transactions and accounts. The company aims to simplify complex billing and payment processes for businesses.

📋 Description

• Implement and maintain Nimble’s managed care contracting strategy in a multi-state environment • Manage and maintain accurate files for pending and executed managed care contracts • Provide timely network updates to clients • Serve as the external negotiator with payers on behalf of healthcare facilities and individual providers • Handle outreach, communication, and contracting logistics • Analyze contract terms, reimbursement structures, and financial impact using data models and payer data • Develop actionable recommendations and present findings directly to provider clients • Partner with clients to understand goals and challenges and tailor negotiation strategies • Assist in resolving billing or contractual issues with insurance carriers • Evaluate, negotiate, and renegotiate managed care contracts with health plans, hospitals/health systems, IPAs, government programs, and other payers • Load and validate payer contract terms, rates, and fee schedules into client systems • Ensure organized documentation and version control for contract files and payer communications • Track and interpret regulatory updates, policy changes, and market trends affecting client reimbursement • Support client projects, including payer escalations, audits, and strategic network decisions • Participate in departmental training and staff meetings

🎯 Requirements

• Strong analytical and critical thinking skills with the ability to interpret complex data and synthesize into client-ready insights • Demonstrated experience negotiating externally with payers or acting as a liaison between payers and providers is highly preferred • Excellent communication and presentation skills — ability to explain data-driven recommendations to non-technical stakeholders • Highly organized and detail-oriented; able to manage multiple priorities and deadlines in a fast-paced environment • Familiarity with managed care contracts, reimbursement methodologies, and payer systems strongly preferred • Proficiency in Excel and financial modeling tools • Bachelor's degree in Healthcare Administration, Business, Finance, or a related field preferred • Adherence to all compliance and company policies and procedures

🏖️ Benefits

• Hybrid or remote work arrangement • Participation in departmental training and staff meetings