Contracts Manager – Payor, MCO, Medicaid

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

📋 Description

• Engage in contract negotiations with payors, MCOs, Medicare Advantage, and government programs in collaboration with the sales team.

• Facilitate internal coordination with legal, finance, compliance, and business development teams to ensure contracts align with the organizational strategy.

• Maintain a comprehensive repository of executed contracts and monitor key terms, renewal dates, and deliverables.

• Oversee ongoing compliance with contract terms and assist in resolving any disputes or audits.

• Collaborate with product and commercial teams to enhance market access strategies.

• Manage the entire lifecycle of healthcare-related contracts, ensuring compliance with regulatory requirements, organizational strategy, and financial goals.

• Lead cross-functional contract implementation projects from inception to completion.

• Create timelines, manage stakeholders, and report progress to leadership.

⛳️ Requirements

• 5–8+ years of progressive experience in managing healthcare-related contracts.

• Demonstrated success in negotiating, drafting, and managing agreements with payors, MCOs, and Medicare Advantage.

• Extensive knowledge of Medicare and Medicaid programs, reimbursement methodologies, and regulatory frameworks.

• Familiarity with value-based care, capitation models, and fee-for-service contracts.

• Direct experience in healthcare contracting, particularly with health plans, provider networks, or healthcare technology companies.

• Understanding of CMS guidelines, HIPAA compliance, and state Medicaid regulations.

• Knowledge of Medicare Advantage and MCOs, including Stars, CAHPS, and risk adjustment programs.

• Ability to lead cross-functional contract implementation projects from start to finish.

• Experience in developing timelines, managing stakeholders, and reporting status to leadership.

• Proficient in project management tools (e.g., Jira, Asana, MS Project, or similar).

• Strong grasp of contract lifecycle management.

• Proficient in Excel and legal/financial modeling related to reimbursement or contract terms.

• Ability to analyze and interpret legal and financial risks within contract terms.

• Bachelor's degree required.

• Excellent communication and negotiation abilities.

• Strong attention to detail and a risk mitigation mindset.

• Capacity to work both independently and collaboratively in a fast-paced, innovative environment.

• Experience in start-up or high-growth settings is highly valued.

• Understanding of elder care markets, digital health, or assistive robotics.

• Familiarity with AI-enabled healthcare solutions or remote care delivery models.

• Experience with Medicare Advantage, Medicaid, or Dual Eligible Special Needs Plans (D-SNPs).

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance.

• 401(k) plan with company match.

• Generous paid time off and holiday policy.

• Opportunities for professional development and growth.

• Collaborative and innovative work environment.