Senior Contracting Specialist

VENTRA Health; United States; A distancia; USD 90.000 - 130.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Performance-based incentive plan

Referral bonus

Rewards & Recognition program

Descripción de la vacante

Ventra Health is seeking a Senior Contracting Specialist to drive payer negotiations, contract analysis, and documentation for a portfolio of provider clients. This role requires hands-on experience in managed care contracting and strong cross-functional collaboration with Legal, Finance, and Revenue Cycle teams.

You will lead negotiations, prepare rate benchmarks, and help optimize contract terms to improve reimbursement outcomes while mentoring junior staff and ensuring client satisfaction.

Formación

• 5+ years of experience in managed care/payer contracting, on payer or provider side
• Experience negotiating payer agreements and interpreting contract language
• Knowledge of reimbursement methodologies including FFS, RBRVS, capitation, and value-based arrangements

Responsabilidades

• Lead contract negotiations with payers across FFS and value-based models
• Develop rate benchmarking and financial impact summaries
• Identify rate optimization opportunities and contract structures
• Review payer contract language across contexts and maintain up-to-date documentation
• Mentor junior staff on contract interpretation and negotiation best practices
• Partner with Revenue Cycle, AR, and Billing to operationalize contract terms
• Support translation of clinical program details into reimbursable terms
• Collaborate with Legal, Finance, and Client Success on contract matters
• Maintain relationships with payer contacts and participate in client meetings

Conocimientos

Negotiation

Contract management

Excel

Client communication

AI tools

Educación

Bachelor's degree in Healthcare Administration, Business, Finance, or related field

Herramientas

Ironclad

Project management tools

Descripción del empleo

About Us

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

Come Join Our Team!

• As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards

Help Us Grow Our Dream Team - Join Us, Refer a Friend, and Earn a Referral Bonus!

Job Summary

• We are seeking a Senior Contracting Specialist to join our Payer Strategy & Contracting team, reporting to the Manager, Payor Strategy & Contracting. This is a senior individual contributor role for a candidate with hands-on payer contracting experience - gained either on the payer side (health plan network management or contracting) or the provider side (medical group, IPA, hospital, or ancillary provider contracting). The Senior Contracting Specialist independently manages contract negotiation, analysis, and documentation for an assigned portfolio of provider clients and facilities on behalf of our clients, operating with a sense of urgency and comfort under pressure. This is a client-facing role responsible for resolving escalated client concerns related to payer contracts and reimbursement, while also serving as a resource to Contracting Specialists on the team.

Essential Functions and Tasks

Payer Strategy & Negotiation

• Conduct contract negotiation discussions on behalf of clients with payers across fee-for-service (FFS) and value-based contract models, escalating high-complexity or high-value negotiations to the Manager as needed
• Develop negotiation materials including rate benchmarking, reimbursement trend analysis, and financial impact summaries
• Identify rate optimization opportunities within the assigned book of business and recommend contract structures that support improved rates
• Review and interpret payer contract language across payer, medical group/IPA, and hospital/ancillary contexts
• Apply working knowledge of managed care frameworks, reimbursement methodologies, and applicable healthcare regulations to contract review and negotiation
• Maintain accurate, up-to-date documentation of payer contracts, amendments, fee schedules, and client communication logs
• Serve as a subject-matter resource and informal mentor to Contracting Specialists on contract interpretation and negotiation best practices

Deal Execution & Financial Alignment

• Partner with Revenue Cycle, AR, and Billing teams to ensure contract terms are accurately operationalized within systems and workflows
• Support translation of clinical program details - including virtual care, hospital-based professional services, and multi-site models - into reimbursable contract terms
• Identify and identify discrepancies between contracted terms and actual payer performance
• Assist in preparing contract terms for client and client’s legal counsel for review

Cross-Functional Collaboration

• Act as a key liaison between Payer Strategy & Contracting and internal stakeholders - including Legal, Finance, Service Delivery, and Client Success - on contract-related matters
• Provide clear, timely updates to the Manager on contract status, risks, and negotiation progress
• Support audit readiness and compliance with payer requirements, including documentation and contract interpretation guidance

Client & Payer Relationship Management

• Serve as a client-facing point of contact for assigned accounts, fielding and resolving escalated client concerns related to payer contracts, reimbursement, and payer performance
• Maintain working relationships with assigned payer contacts and represent the organization in routine payer meetings and operational reviews
• Participate in client meetings or calls to support strategic initiatives and provide status updates on contracting activity
• Track payer reimbursement trends, policy changes, and competitive dynamics relevant to the assigned book of business
• Escalate emerging payer or client risks and opportunities to the Manager

Analytics & Performance Monitoring

• Analyze payer performance, denial trends, and payment variances within the assigned portfolio to identify and act on improvement opportunities
• Support development of payer scorecards and KPIs to evaluate contract effectiveness
• Contribute to financial models supporting contracting, re-contracting, and new market entry decisions

Education and Experience Requirements

Required

• 5+ years of experience in managed care/payer contracting, gained on either the payer side (health plan contracting or network management) or the provider side (medical group, IPA, hospital, or ancillary provider contracting)
• Demonstrated experience negotiating payer agreements and interpreting contract language
• Working knowledge of reimbursement methodologies, including FFS, RBRVS, capitation, and value-based arrangements
• Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field, or equivalent experience

Preferred

• Experience on both the payer and provider sides of contracting
• Familiarity with Medicaid, Medicare Advantage, and/or pediatric reimbursement structures
• Experience mentoring or guiding junior contracting staff
• Experience collaborating with offshore or distributed team members
• AAHAM and/or HFMA certification

Knowledge, Skills, and Abilities

Required

• Ability to operate under pressure and manage multiple concurrent negotiations with a strong sense of urgency
• Demonstrated experience operating in a client-facing capacity, with the ability to professionally manage and resolve escalated client concerns
• Proficiency with Excel, contract management systems (e.g., Ironclad or comparable platforms), and project management tools
• Working proficiency with company-approved AI tools (Claude, Microsoft Copilot) to support contract analysis, drafting, and workflow efficiency
• Strong written and verbal communication skills, with the ability to represent the organization credibly in payer-facing conversations
• High attention to detail in contract review, interpretation, and documentation

Compensation

• Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons.

• This position is also eligible for a discretionary incentive bonus in accordance with company policies.

Ventra Health

Equal Employment Opportunity (Applicable only in the US)Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions.Recruitment AgenciesVentra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.Solicitation of PaymentVentra Health does not solicit payment from our applicants and candidates for consideration or placement.

Statement of AccessibilityVentra Health is committed to making our digital experiences accessible to all users, regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. Please review at https://ventrahealth.com/statement-of-accessibility/.