Senior Contracting Specialist

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🔥 27 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

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Ventra Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2021

🏥 Healthcare

☁️ SaaS

🤝 B2B

Healthcare • SaaS • B2B

Ventra Health is a healthcare revenue cycle management (RCM) company that provides end-to-end medical billing, coding, claims management, denial prevention, payer contracting, and collections services for hospitals, health systems, and physician practices across the U. S. Its offerings combine domain expertise and white‑glove client service with proprietary data and AI-powered platforms—vCision (AI & automation) and vSight (data & analytics)—to improve reimbursement, reduce denials, accelerate cash collections, and deliver measurable RCM performance improvements. Ventra emphasizes enterprise service delivery, provider education, compliance and coding audits, patient responsibility management, and payer strategy, serving thousands of providers and facilities nationwide.

📋 Description

• Conduct contract negotiation discussions on behalf of clients with payers across fee-for-service and value-based contract models • Develop negotiation materials including rate benchmarking, reimbursement trend analysis, and financial impact summaries • Identify rate optimization opportunities and recommend contract structures that support improved rates • Review and interpret payer contract language across payer, medical group/IPA, and hospital/ancillary contexts • Maintain accurate documentation of payer contracts, amendments, fee schedules, and client communication logs • Serve as a subject-matter resource and informal mentor to Contracting Specialists • Partner with Revenue Cycle, AR, and Billing teams to operationalize contract terms in systems and workflows • Support translation of clinical program details into reimbursable contract terms • Identify and escalate discrepancies between contracted terms and actual payer performance • Assist in preparing contract terms for client and legal counsel review • Liaise with Legal, Finance, Service Delivery, and Client Success on contract-related matters • Provide the Manager with updates on contract status, risks, and negotiation progress • Support audit readiness and compliance with payer requirements • Serve as a client-facing point of contact for assigned accounts and resolve escalated concerns • Maintain relationships with payer contacts and represent the organization in payer meetings and operational reviews • Participate in client meetings and calls to support strategic initiatives • Track payer reimbursement trends, policy changes, and competitive dynamics • Analyze payer performance, denial trends, and payment variances • Support development of payer scorecards and KPIs • Contribute to financial models for contracting, re-contracting, and new market entry decisions

🎯 Requirements

• 5+ years of experience in managed care/payer contracting, gained on either the payer side (health plan contracting or network management) or the provider side (medical group, IPA, hospital, or ancillary provider contracting) • Demonstrated experience negotiating payer agreements and interpreting contract language • Working knowledge of reimbursement methodologies, including FFS, RBRVS, capitation, and value-based arrangements • Bachelor's degree in Healthcare Administration, Business, Finance, or a related field, or equivalent experience • Ability to operate under pressure and manage multiple concurrent negotiations with a strong sense of urgency • Demonstrated experience operating in a client-facing capacity, with the ability to professionally manage and resolve escalated client concerns • Proficiency with Excel, contract management systems (e.g., Ironclad or comparable platforms), and project management tools • Working proficiency with company-approved AI tools (Claude, Microsoft Copilot) to support contract analysis, drafting, and workflow efficiency • Strong written and verbal communication skills, with the ability to represent the organization credibly in payer-facing conversations • High attention to detail in contract review, interpretation, and documentation

🏖️ Benefits

• Ventra performance-based incentive plan • Discretionary incentive bonus in accordance with company policies • Referral bonus

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