Contract Manager, Managed Care

Bookmark Medical; Massachusetts; Híbrido; USD 85.000 - 110.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical coverage

Dental coverage

Vision coverage

Company funded HSA

401(k) with match

Flexible time off

Vacation Exchange Program

Certification reimbursement

Descripción de la vacante

Bookmark Medical is seeking a Contract Manager for managed care with responsibilities spanning negotiations, implementation, and ongoing administration of provider contracts. You will handle both fee-for-service and value-based arrangements, coordinate with health plans and internal teams, and monitor performance to drive favorable financial and operational outcomes.

This hybrid role requires in-office days weekly in our Massachusetts or Tennessee offices.

Formación

• Bachelor’s degree in Business Administration, Healthcare Administration, Finance, Economics, or related field.
• 5+ years experience in managed care contracting, provider contracting, or healthcare finance.
• Experience negotiating value-based and fee-for-service arrangements with health plans.
• Strong understanding of provider reimbursement methodologies.

Responsabilidades

• Negotiate and manage contracts for Commercial, Medicare Advantage, and Medicaid lines.
• Negotiate FFS reimbursement schedules and other methodologies.
• Evaluate proposals and financial/operational impact of terms.
• Develop negotiation positions with supporting analyses.
• Coordinate contract implementation across internal departments.
• Maintain relationships with payer contracting and network teams.
• Monitor performance and resolve operational issues related to contracts.

Conocimientos

Negotiation

Communication

Relationship management

Problem-solving

Analytical skills

Educación

Bachelor’s degree

Herramientas

Microsoft Excel

Descripción del empleo

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Contract Manager, Managed Care

Full Time - 30 hours or more Nashville, TN, US

Provider-Centered. Patient-Focused. Built for What Healthcare Should Be.

At Bookmark Medical, we are building a healthcare experience rooted in trust, teamwork, compassion, and continuous progress. We believe the best care happens when providers and care teams have the support, technology, and resources they need to focus on what matters most-patients.

Our mission is simple: improve lives through high-quality continuous care. Through connected care teams, innovative tools, and collaborative culture, we are creating a healthcare experience where patients are known, supported, and never have to start over.

Whether you are caring directly for patients, supporting operations, or helping grow our organization, you will join a team that values your expertise, encourages your growth, and empowers you to make a meaningful impact every day.

If you are looking for more than just a job, if you are looking for a purpose-driven career where your work truly matters, we would love to meet you.

Position Summary

The Contract Manager is responsible for the negotiation, implementation, and ongoing management of managed care agreements on behalf of the Bookmark Medical's provider network. This role manages both fee-for-service (FFS) and value-based care (VBC) arrangements and serves as a key point of contact between the organization, health plan partners, and internal operational teams.

The Contract Manager will assist in managing payor negotiations, evaluate reimbursement and contractual terms, coordinate contract implementation, and resolve operational issues affecting contract performance. The successful candidate will have demonstrated managed care negotiation experience, strong knowledge of provider reimbursement, and experience working with value-based arrangements.

Managed Care Contracting & Negotiation

• Manage negotiations for new agreements, renewals, amendments, and reimbursement changes with health plan partners related to Commercial, Medicare Advantage, and Medicaid lines of business.
• Negotiate fee-for-service reimbursement, including physician fee schedules, percentage-of-Medicare arrangements, and other reimbursement methodologies.
• Evaluate payer proposals and reimbursement terms to determine financial and operational impact.
• Develop negotiation positions and supporting analyses using reimbursement data, market information, organizational performance, and other relevant information.
• Review and negotiate key contractual provisions related to reimbursement, payment policies, term and termination, claims, timely filing, audits, overpayments, dispute resolution, and other material terms.
• Maintain productive relationships with payer contracting and network management representatives.

Value-Based & Risk Contracting

• Negotiate and manage value-based arrangements, including quality incentives, shared savings, shared risk, total cost of care, capitation, and other risk-based models.
• Evaluate key components of value-based arrangements, including financial benchmarks, trend, risk adjustment, attribution, quality measures, risk corridors, stop-loss provisions, and settlement methodologies.
• Partner with Finance, Analytics, Quality, Population Health, and operational teams to monitor contractual performance and identify opportunities or areas of concern.
• Review payer performance reports and settlement calculations for consistency with contractual requirements.
• Assist in evaluating new value-based opportunities and determining their financial and operational implications.
• Work with payer partners to resolve discrepancies involving attribution, financial performance, quality results, or settlement calculations.

Contract Implementation & Operations

• Serve as a primary point of contact for operational issues related to managed care agreements.
• Coordinate implementation of new contracts, amendments, reimbursement changes, and value-based arrangements across applicable internal departments.
• Partner with Revenue Cycle, Credentialing, Finance, Analytics, Operations, and other teams to ensure negotiated terms are implemented accurately.
• Manage and resolve payer issues involving claims reimbursement, fee schedules, provider loading, credentialing, eligibility, products, attribution, reporting, and other contract-related matters.
• Identify systemic reimbursement or operational issues and coordinate with health plans and internal stakeholders to drive resolution.
• Validate that negotiated reimbursement and other material contract changes are implemented accurately and timely.
• Escalate significant contractual or operational issues when appropriate and track issues through resolution.

Contract Administration & Analysis

• Maintain an organized inventory of managed care agreements, amendments, fee schedules, and related documentation.
• Monitor contract renewal dates, notice requirements, termination provisions, and other key contractual deadlines.
• Prepare clear summaries of material financial, operational, and contractual provisions for internal stakeholders.
• Interpret contractual requirements and communicate their implications to operational and business teams.
• Monitor payer policies and contractual changes that may affect reimbursement or contract performance.
• Maintain documentation of negotiations, contract decisions, implementation activities, and outstanding payer issues.
• Support leadership with contract analyses, payer updates, and other managed care reporting as needed.

Qualifications

Required Qualifications

• Bachelor’s degree in Business Administration, Healthcare Administration, Finance, Economics, or a related field.
• 5+ years of experience in managed care contracting, provider contracting, network contracting, healthcare finance, or a related healthcare field.
• Experience negotiating, managing, or evaluating value-based arrangements and fee-for-service reimbursement arrangements with health plans.
• Strong understanding of provider reimbursement methodologies and managed care contracting for Commercial, Medicare Advantage, and/or Medicaid managed care products.
• Ability to interpret complex contractual language and understand its financial and operational implications.
• Strong analytical and financial skills, including the ability to evaluate reimbursement proposals and contract performance.
• Strong negotiation, communication, relationship-management, and problem-solving skills.
• Ability to independently manage multiple negotiations, payer relationships, implementation activities, and operational issues simultaneously.
• Proficiency with Microsoft Excel and other Microsoft Office applications.

Preferred Qualifications

• Experience working for or contracting on behalf of a physician group, medical group, clinically integrated network, ACO, other provider organization, or health plan.
• Experience with total-cost-of-care, shared-risk, or global-risk arrangements.
• Knowledge of risk adjustment, attribution, medical cost trends, quality incentives, and value-based settlement methodologies.
• Familiarity with Medicare reimbursement methodologies and physician fee schedules.
• Experience resolving complex claims, reimbursement, and payer implementation issues.

Position Expectations

• The Contract Manager is expected to independently manage assigned payer relationships and contract negotiations from initial analysis through execution and implementation. The role requires the ability to balance financial objectives, contractual protections, operational considerations, and long-term payer relationships.
• Hybrid role requiring days in either our Massachusetts or Tennessee office each week
• Travel up to 10%

Why You Will Love Working Here

We take care of our team so they can take care of patients. Benefits include:

• Medical, dental, and vision coverage
• Company funded HSA + exclusive healthcare discounts
• 401(k) with company match
• Flexible time off + Vacation Exchange Program
• Medical Assistant Certification Reimbursement

What We Value

Trust. Ownership (Together). Compassion. Relentless Progress . These values shape how we show up for patients - and for each other.

Bookmark Medical is committed to a workplace that supports and sustains inclusion and belonging.

Bookmark Medical does not discriminate in employment opportunities or practices on the basis of race, color, religion, gender, national origin, age, physical or mental disability, pregnancy, childbirth or related medical conditions, military service obligations, citizenship, sexual orientation, genetic information, or any other characteristic protected by applicable local, state, or federal law.