Specialist III, Contract Management & Implementation
Accountabilities Contract Review and Interpretation: Review and interpret payer contracts, amendments, provider manuals, and policies ahead of new payer launches, documenting key terms and identifying ambiguous or potentially risky language.
Risk Identification and Escalation: Flag contractual issues with clear context, explain potential downstream implications, and recommend appropriate next steps to support timely resolution.
Contract Documentation and Support: Serve as a reliable resource for contract-related questions, maintaining accurate documentation that supports billing, eligibility, payer implementation, and revenue cycle operations.
Contract Repository Development: Help build and operationalize a centralized, searchable contract repository by organizing, migrating, and standardizing contract documentation and defining key contractual terms.
AI-Powered Contract Intelligence: Support the development and improvement of AI-enabled payer intelligence tools by validating search accuracy, reviewing outputs, and ensuring relevant contract information can be retrieved reliably.
Cross-Functional Collaboration: Partner with payer partnerships, payer launch, billing, and revenue cycle teams to resolve flagged risks, close documentation gaps, and obtain clarification from payer partners when needed.
Reimbursement Analysis: Analyze reimbursement methodologies and contractual provisions to help maintain financial accuracy and reduce downstream billing and collections issues.
Process Improvement: Identify opportunities to streamline contract management workflows, improve documentation quality, and modernize processes as the contract portfolio expands.
Requirements:
Hands-on experience with payer contracts, contract amendments, provider manuals, payer policies, or similar healthcare documentation.
Ability to locate, navigate, review, and interpret complex contractual documents and accurately extract relevant terms, obligations, and operational requirements.
Exceptional attention to detail and a strong commitment to documentation accuracy, recognizing the financial and operational consequences of misinterpreted contract language.
Strong analytical judgment and the ability to recognize ambiguity, identify contractual risks, assess downstream implications, and escalate issues with clear explanations and recommended actions.
Excellent written and verbal communication skills, including the ability to convey complex contract information clearly and effectively to cross-functional stakeholders.
A proactive, self-directed approach to problem-solving, with the ability to identify process improvements, manage competing priorities, and work effectively in an evolving environment.
Comfort working with incomplete information and navigating ambiguity while maintaining accuracy and sound professional judgment.
Familiarity with healthcare revenue cycle operations, including timely filing requirements, reimbursement provisions, claim routing, billing, and collections, is a plus.
Experience with behavioral health payer contracts or healthcare reimbursement is an advantage.
Interest in contract repository management, data organization, and AI-enabled tools for document search and information retrieval is beneficial.
Employment classification: Full-time, hourly, non-exempt position.
Location: The role is fully remote and advertised for U.S. employees.
Benefits:
Hourly compensation: The posting lists a range of $25.00–$28.84 per hour in its compensation section and separately states a fully remote rate of $28.85 per hour. The applicable rate should be confirmed during the hiring process.
Healthcare coverage: Medical, dental, vision, life, and disability insurance.
Mental health support: No-cost access to therapy through the company’s platform for eligible U.S. employees.
Retirement and financial wellness: Retirement savings programs and equity opportunities.
Flexible time off: Flexible paid time off, company-paid holidays, and a company-wide winter break.
Parental leave: Up to 18 weeks of paid parental leave, along with a stipend for a new child.
Wellbeing time: Dedicated weekly flexible time for self-care, including therapy, exercise, journaling, family time, or rest.
Wellness and professional development: An annual stipend to support personal wellbeing, education, fitness, books, and learning resources.
Home office support: Benefits to support a productive home workspace.
Meal benefits: Meal-related benefits tailored to remote and hub-based employees.
Additional perks: Wellness memberships, virtual care, pet insurance discounts where available, and global travel assistance.
Commuter benefits: Pre-tax commuter benefits for employees working from designated hub locations.
Inclusive workplace: A commitment to equal employment opportunity and consideration of candidates with diverse backgrounds and transferable skills.
How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether?
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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