Managed Markets Contract Specialist
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AI Summary
The specialist serves as the primary contact for assigned payers and manages the organization's contract management system. They negotiate contract terms and pricing while supporting franchise leaders and revenue cycle teams with payer requirements.
Recognized as a “Best Place to Work Modern Healthcare” – Join a team where people come first. At Vital Care, we are committed to creating an inclusive, growth-focused environment where every voice matters.
Vital Care is the premier pharmacy franchise business with franchises serving a wide range of patients, including those with chronic and acute conditions. Since 1986, our passion has been improving the lives of patients and healthcare professionals through locally-owned franchise locations across the United States. We have over 100 franchised Infusion pharmacies and clinics in 35 states, focusing on the underserved and secondary markets. We know infusion services, and we guide owners along the path of launch, growth, and successful business operations.
What we offer:
- Comprehensive medical, dental, and vision plans, plus flexible spending, and health savings accounts.
- Paid time off, personal days, and company-paid holidays.
- Paid Paternal Leave.
- Volunteerism Days off.
- Income protection programs include company-sponsored basic life insurance and long-term disability insurance, as well as employee-paid voluntary life, accident, critical illness, and short-term disability insurance.
- 401(k) matching and tuition reimbursement.
- Employee assistance programs include mental health, financial and legal.
- Rewards programs offered by our medical carrier.
- Professional development and growth opportunities.
- Employee Referral Program.
Job Summary:
Under the direction of the VP Managed Markets, the Managed Markets Contract Specialist will contact and be the main contact for assigned to payers; as well as assist Revenue Cycle and franchise leaders with contract-related needs, and maintaining the organization’s contract management system. This role ensures accurate contract records and helps facilitate smooth operations across commercial, Medicare, and Medicaid payers.
Duties/Responsibilities:
- Payer Outreach and Contracting
- As directed by the VP, Managed Markets, the Contracts Specialist will work with assigned Commercial, Medicare, and Medicaid payers to request participation agreements and network enrollment.
- In conjunction with the Director, the Contract Specialist will negotiate contract terms and pricing to align with organizational objectives
- Follow up on pending applications and contracts, maintain communication with payer representatives.
- Franchise Support
- Participate in franchise onboarding activities for managed care related issues
- Assist franchise leaders with understanding payer requirements and contract details.
- Serve as a resource for operational teams regarding billing guidelines and contract status.
- Contract Management System
- Maintain and update the contract management system with accurate contract terms, effective dates, and renewal timelines.
- Track contract status and ensure timely updates for internal stakeholders.
- Cross-Functional Collaboration
- Work closely with Revenue Cycle, Credentialing, and Operations teams to ensure contracts are implemented correctly.
- Communicate payer updates and changes to internal teams.
- Internal Communication
- Share updates on payer status and contract changes with internal teams.
- Support revenue cycle and operations teams with contract-related information.
Required Skills/Abilities:
- Strategic thinking and problem- solving skills
- Strong organizational and communication skills.
- Ability to manage multiple priorities and maintain accurate records.
- Proficiency in Microsoft Office and contract management systems.
Preferred:
- Familiarity with commercial, Medicare, and Medicaid payer contracting.
- Understanding of home infusion or specialty pharmacy operations.
Education and Experience:
- Bachelor’s degree in Healthcare Administration, Business, or related field preferred.
- 2–3 years in healthcare contracting, payer relations, or provider enrollment (home infusion or specialty pharmacy experience a plus).
Physical Requirements:
- Sitting: Prolonged periods of sitting are typical, often for the majority of the workday.
- Keyboarding: Frequent use of a keyboard for typing and data entry.
- Reaching: Occasionally reaching for items such as files, documents, or office supplies.
- Fine Motor Skills: Precise movements of the fingers and hands for tasks like typing, using a mouse, and handling paperwork
- Visual Acuity: Good vision for reading documents, computer screens, and other detailed work.
Be part of an organization that invests in you! We are reviewing applications for this role and will contact qualified candidates for interviews.
Vital Care Infusion Services is an equal-opportunity employer and values diversity at our company. We do not discriminate on the basis of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans’ status, or any other basis protected by applicable federal, state, or local law.
Vital Care Infusion Services participates in E-Verify.
Vital Care Infusion Services is an equal-opportunity employer and values diversity at our company. We do not discriminate on the basis of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans’ status, or any other basis protected by applicable federal, state, or local law.
Vital Care Infusion Services participates in E-Verify.
This position is full-time and remote. The salary range for this position is $75,000-$90,000.
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