Managed Care Contract Negotiator – Hybrid/Remote

Nimble Solutions; Virginia; Hybrid; USD 60.000 - 90.000; Vollzeit

Zusammenfassung

Nimble Solutions in the United States is hiring a Contract Specialist in the Managed Care Department. The role focuses on implementing and maintaining our multi-state managed care contracting strategy, with hybrid/remote options from the Chesterfield office.

You will manage contract files, negotiate with payers, analyze terms and financial impact, and present recommendations to provider clients. Collaboration with clients to align goals is key, along with resolving billing or contract issues.

Qualifikationen

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

Aufgaben

• 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

Kenntnisse

Analytical thinking

Communication skills

Detail-oriented

Ausbildung

Bachelor's degree in Healthcare Administration

Tools

Excel

Financial modeling tools

Jobbeschreibung

Nimble Solutions in the United States is hiring a Contract Specialist in the Managed Care Department. The role focuses on implementing and maintaining our multi-state managed care contracting strategy, with hybrid/remote options from the Chesterfield office.

You will manage contract files, negotiate with payers, analyze terms and financial impact, and present recommendations to provider clients. Collaboration with clients to align goals is key, along with resolving billing or contract issues.