Managed Care Analytics & Reimbursement Specialist

Blue-and-Compan; Richardson (TX); On-site; USD 75,000 - 110,000; Full time

Job summary

Blue & Co., LLC is seeking a Managed Care Specialist to provide subject matter expertise in managed care contracts and reimbursement modeling for healthcare provider clients. The role collaborates with the Healthcare Reimbursement and Revenue Cycle teams to address reimbursement challenges with accuracy and insight.

The ideal candidate will analyze contract terms, build models, and support negotiations while communicating findings clearly to providers, payers, and internal teams.

Qualifications

• 2–6 years of managed care experience, including review and negotiation of payer contracts.
• Experience with contract modeling and payment methodologies.
• Strong Excel and data analysis skills.
• Excellent written and verbal communication skills.
• Ability to work independently in a fast-paced environment.
• Understanding of value-based contracting principles.
• Strong organizational and documentation skills.
• Ability to lead meetings and deliver presentations.

Responsibilities

• Interpret contract terms, payment methodologies, and reimbursement hierarchies to identify risks and opportunities for healthcare provider clients.
• Interview provider personnel to gather information on payer relationships, contract performance, and historical reimbursement trends.
• Define issues, develop practical work plans, and support implementation of recommended solutions.
• Support managed care contract negotiations by prioritizing client needs and goals.
• Build and maintain productive relationships with payers and providers.
• Review, test, and analyze utilization and reimbursement data sets.
• Develop and maintain financial and reimbursement models using database/spreadsheet tools.
• Prepare exhibits, analyses, and narrative reports communicating findings.
• Communicate with healthcare providers, health plans, and internal teams.

Skills

Analytical skills

Excel

Word

Verbal communication

Written communication

Attention to detail

Interpersonal skills

Independent work

Presentation skills

Stakeholder management

Tools

Microsoft Excel

Microsoft Word

Database / analytics tools

Job description

Blue & Co., LLC is seeking a Managed Care Specialist to provide subject matter expertise in managed care contracts and reimbursement modeling for healthcare provider clients. The role collaborates with the Healthcare Reimbursement and Revenue Cycle teams to address reimbursement challenges with accuracy and insight.

The ideal candidate will analyze contract terms, build models, and support negotiations while communicating findings clearly to providers, payers, and internal teams.