Contracts Manager

This is a fully remote position, open to applicants in Florida.

📋 Description

• Manage payer contract activities in the Revenue Cycle Management department for home health and durable medical equipment services.

• Act as the subject matter expert on payer reimbursement terms, contract interpretation, fee schedules, and operational requirements impacting billing and collections.

• Collaborate with payers, revenue cycle leadership, compliance, credentialing, billing operations, and IT/system teams to convert contract terms into workflows and system configurations.

• Supervise a Contracts Specialist tasked with entering payer pricing, fee schedules, and contractual obligations into company systems and electronic networks.

• Evaluate, analyze, and uphold payer contracts for home health and DME services.

• Interpret reimbursement methodologies, fee schedules, billing regulations, authorization requirements, and payer-specific compliance duties.

• Identify the operational effects of payer contract terms and convey requirements to relevant departments.

• Monitor contract performance and reimbursement trends to detect discrepancies, underpayments, and opportunities for revenue leakage.

• Collaborate on contract renewals, amendments, and negotiations with payers by providing operational and financial insights.

• Maintain a centralized repository for payer contracts and associated documentation.

• Define and document payer requirements for integration into company systems, ENS platforms, and billing processes.

• Ensure accurate configuration and maintenance of payer-specific pricing, billing edits, authorization rules, and reimbursement requirements.

• Work with IT, billing, and operational teams to validate system setups and resolve configuration issues impacting claims or reimbursement.

• Manage testing and validation for payer updates, fee schedule changes, and system enhancements.

• Review and authorize fee schedule uploads and payer configuration updates.

• Provide training, guidance, and performance management for direct reports.

• Develop and uphold standard operating procedures for payer contract implementation and maintenance.

• Ensure contract requirements adhere to federal, state, and payer regulations.

• Assist billing, collections, intake, and operational teams with contract interpretation and payer requirements.

• Support audits, appeals, and reimbursement investigations.

• Promote continuous improvement initiatives aimed at enhancing reimbursement accuracy.

• Execute all other related duties as assigned.

⛳️ Requirements

• Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field is preferred.

• At least 5 years of experience in healthcare revenue cycle, managed care contracting, payer relations, or DME/home health reimbursement.

• Strong grasp of home health and DME payer reimbursement methodologies, billing requirements, and revenue cycle operations.

• Experience in interpreting managed care contracts and converting contract terms into operational requirements.

• Prior experience managing or supervising staff is preferred.

• Familiarity with Medicare, Medicaid, commercial insurance, and managed care payer frameworks.

• Experience with healthcare billing systems, fee schedule management, and payer configuration processes.

• Strong analytical, organizational, and problem-solving capabilities.

• Excellent communication skills and ability to collaborate cross-functionally.

• Comprehensive knowledge of the managed care industry and product administration/implementation.

• IHCS is an equal opportunity employer dedicated 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.