Contract Specialist, Managed Care

nimble solutions; Chesterfield (MO); On-site; USD 60,000 - 90,000; Full time

Job summary

Nimble Solutions seeks a Contract Specialist to implement and maintain a managed care contracting strategy across multiple states. You will be the external negotiator with payers, analyze contract terms, and assess financial impact using data models.

You will collaborate with clients to understand goals, tailor negotiation approaches, and resolve billing or contractual issues with insurers, driving favorable outcomes in a fast-paced revenue cycle environment.

Qualifications

• 0-2 years of experience; recent grads with a degree in Healthcare Administration or Business encouraged to apply
• Strong analytical and critical thinking skills with the ability to interpret complex data and synthesize into client-ready insights
• Excellent communication and presentation skills — ability to explain data-driven recommendations to non-technical stakeholders
• Highly organized and detail-oriented; able to manage multiple priorities and deadlines in a fast-paced environment
• Demonstrated familiarity with managed care contracts, reimbursement methodologies, and payer systems is a plus but not required

Responsibilities

• Manage and maintain accurate files for each pending and executed managed care contract; provide timely network updates to clients
• Serve as the external negotiator with payers on behalf of healthcare facilities and providers, handling outreach and contracting logistics
• Analyze contract terms, reimbursement structures, and financial impact using data models and payer data
• Develop clear, actionable recommendations based on analysis and present findings to the provider client
• Partner with clients to understand goals and tailor negotiation strategies accordingly
• Assist in resolving billing or contractual issues with insurance carriers, advocating on the client’s behalf
• Evaluate and renegotiate contracts with health plans, hospitals, IPAs, government programs, and other payers
• Load and validate payer contract terms, rates, and fee schedules into client systems with accuracy
• Ensure organized documentation and version control for all contract files and payer communications
• Track regulatory updates, policy changes, and market trends that may affect client reimbursement
• Support additional client projects including payer escalations, audits, and strategic network decisions

Skills

Excel

Financial modeling

Data analysis

Negotiation

Analytical thinking

Education

Bachelor's in Healthcare Administration

Business/Finance-related degree

Tools

Financial modeling tools

Job description

Who We Are:

Nimble solutions has over 20 years of specialized, surgical-focused revenue cycle management experience that spans across the Ambulatory Surgical Center industry and other affiliated services adjacent to the ASC space, such as anesthesia billing services, professional billing services, transcription services, and many others.

Job Type

Full-time

Description

Who We Are:

Nimble solutions has over 20 years of specialized, surgical-focused revenue cycle management experience that spans across the Ambulatory Surgical Center industry and other affiliated services adjacent to the ASC space, such as anesthesia billing services, professional billing services, transcription services, and many others.

Why You'll Want To Work At Nimble!

We provide services in nearly every US state, and our team of experts works around the globe, managing over $10 billion in net revenue as we continue to build and innovate a world-class organization with people like you. Together, we embrace challenges, fuel innovation, and strive to exceed expectations. Healthcare means a lot more to us. We care about creating an environment where our coworkers, clients, and communities' social, financial, and physical health is at the forefront of everything we do.

What You'll Be Doing Day To Day...

The Contract Specialist is responsible for implementing and maintaining nimble’s managed care contracting strategy in a multi-state environment, and we are looking for candidates to join the Managed Care Department who are eager to learn in a fast-paced environment!

• Manage and maintain accurate files for each pending and executed managed care contract; provide timely network updates to clients
• Serve as the external negotiator with payers on behalf of healthcare facilities and individual providers, handling all aspects of outreach, communication, and contracting logistics
• Analyze contract terms, reimbursement structures, and financial impact using data models and payer data
• Develop clear, actionable recommendations based on your analysis and present findings directly to the provider client
• Partner closely with clients to understand their goals and challenges, and tailor negotiation strategies accordingly
• Assist in resolving billing or contractual issues with insurance carriers, advocating on the client’s behalf
• Evaluate, negotiate, and renegotiate managed care contracts with health plans, hospitals/health systems, IPAs, government programs, and other payers
• Load and validate payer contract terms, rates, and fee schedules into client systems with accuracy and consistency
• Ensure organized documentation and version control for all contract files and related payer communications
• Track and interpret regulatory updates, policy changes, and market trends that may affect client reimbursement
• Support additional client projects, including payer escalations, audits, and strategic network decisions

Requirements

Who You Are!

• 0-2 years of experience; recent graduates with a degree in Healthcare Administration or Business are encouraged to apply!
• Strong analytical and critical thinking skills with the ability to interpret complex data and synthesize into client-ready insights
• Excellent communication and presentation skills — ability to explain data-driven recommendations to non-technical stakeholders
• Highly organized and detail-oriented; able to manage multiple priorities and deadlines in a fast-paced environment
• Proficiency in Excel and financial modeling tools
• Familiarity with managed care contracts, reimbursement methodologies, and payer systems is a plus but not required
• Demonstrated experience negotiating externally with payers or acting as a liaison between payers and providers is a plus but not a must
• Bachelor's degree in Healthcare Administration, Business, Finance, or a related field preferred

Work Environment:

• Participate in departmental training and staff meetings
• Adhere to all compliance and company policies and procedures