Managed Care Contract Specialist

Company DescriptionAegis Health Services is dedicated to driving better patient outcomes through population health management. The organization focuses on improving healthcare delivery by ensuring that patients receive coordinated and comprehensive care. With a strong emphasis on quality, Aegis Health Services strives to create impactful and sustainable solutions in the healthcare industry.Role DescriptionThe Managed Care Contract Specialist will play a key role in obtaining, enrolling, and optimizing payer contracts for Aegis Health Services. This role will directly support revenue cycle in analyzing reimbursement, preparing negotiation strategies, and executing payer contracts. Duties will include but are not limited to:Processing Medicare, Medicaid, and commercial payer enrollments and credentialing for the group and individual providers.Processing revalidations with Medicare, Medicaid, and commercial payers.Researching, soliciting, and negotiating contracts with commercial payers. Preparing payer negotiation materials, including rate comparisons, market benchmarks, and review of price transparencyMonitor contract renewal timelines and proactively identify renegotiation or termination opportunitiesManaging payer relationships including communications, issue resolution, and data requests. Collaborating with the revenue cycle team on underpayments and denials due to provider enrollment and credentialing related issues. Maintaining accurate and up-to-date records in compliance with organizational standards and regulatory requirements.Preparing reports on credentialing activities for management review.QualificationsBachelor's degree in Business, Healthcare Administration, Finance, or related field5+ years of experience in manage care and payer contractingExperience working with national and regional payers such as United Healthcare, Aetna, Cigna, Blue Cross Blue Shield, Humana, and United Healthcare preferredExperience in contract negotiations or payer strategy development preferredAbility to interpret and analyze fee schedules, contracts, and reimbursement termsHighly organized with strong attention to detail and ability to manage multiple projects simultaneouslyKnowledge of claims adjudication, denial management, and payer policies preferredStrong communication skills with the ability to interface with internal leadership and external stakeholdersSalary compensation is based on experience$65,000-$75,000

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