Duration: Contract until end of 2026, possibility of permanent hire or extension
Shift: Monday-Friday, 40 Hours (Start time from 7am-9am in your time zone, 8 consecutive hours).
Key Responsibilities
Load, model, test, and maintain payer contracts and fee schedules within the contract management system, including facility, professional, home care, infusion, and pharmacy services
Represent the provider perspective in contract interpretation, modeling, and operational workflows
Analyze payer contracts to ensure accurate reimbursement logic, including DRG, APC, per diem, case rate, percent of charge, and fee schedule–based methodologies
Support implementation of new payer contracts and amendments, ensuring timely and accurate system setup
Model and operationalize risk-based contracting methodologies, value-based arrangements, and global agreements (including transplant agreements where applicable)
Validate contract modeling through testing, variance analysis, and reconciliation against expected reimbursement
Partner with Revenue Cycle Operations, Managed Care, and Finance to identify reimbursement issues, underpayments, and contract compliance gaps
Provide ongoing contract support, troubleshooting, and education to downstream teams (billing, follow-up, AR, and leadership)
Assist with contract performance analysis, including identifying trends, risks, and optimization opportunities
Maintain documentation of contract terms, modeling assumptions, and system configurations
Required Qualifications
Bachelor’s degree in Finance, Business, Healthcare Administration, or a related field, or equivalent experience
3+ years of experience in payer contract analysis or modeling representing the provider side of the revenue cycle
Strong understanding of healthcare reimbursement and managed care contracting from a provider perspective
Hands-on experience with contract management or modeling systems
Proven experience interpreting payer contracts and translating contract language into executable reimbursement logic
Solid understanding of end-to-end revenue cycle workflows (charging, billing, AR, and reimbursement)