Healthcare Contract Lead

Position Overview
Beacon Hills client is looking for a Healthcare Contract Lead to join their team. The ideal candidate will be responsible for acquiring new contracts and maintaining ongoing relationships with payer accounts. This role requires fostering strong partnerships with payers and colleagues to ensure high levels of client satisfaction and successful contract resolutions. The Healthcare Contract Lead plays a critical role in developing network management strategies that support market growth, compliance, and enhanced member experience.
This remote fulltime opportunity is looking for candidates that have direct experience working with healthcare contracts.
Based on client needs, candidates must sit in a central or eastern time zone.
Key Responsibilities
1 Contract Negotiation: Negotiate contracts with payers and Independent Practice Associations (IPA) across all business lines. Support company growth by developing new contracts and expanding services with existing payers.
2 Contract Analysis: Analyze contracts to assess viability and provide recommendations on reimbursement and contracting strategies.
3 Compliance Management: Apply state and federal regulations to negotiate and manage contracts, ensuring compliance with payer requirements.
4 Credentialing Compliance: Ensure quarterly and annual credentialing requirements are met, maintaining accurate and timely applications.
5 Market Knowledge: Stay up to date with healthcare market trends and growth opportunities in the provider network.
6 Stakeholder Communication: Ensure contract terms, reimbursement rates, and payer policies are clearly communicated to internal stakeholders and reflected in front- and back-end processes.
7 Claims Management: Collaborate with operations teams to identify trends in authorization and claim denials, escalating issues to payer contacts as needed.
8 Collaboration: Work closely with cross-functional teams to support the organizations strategic goals and objectives.
9 Core Values: Demonstrate the departments core philosophies: Listen, Learn, and Lead.
10 Other Duties: Perform other tasks as assigned by the manager.
Required Skills and Qualifications
Knowledge of Payer Processes: In-depth understanding of how payers make decisions regarding CMS codes.
Contract Negotiation Experience: Minimum of 2 years of experience in contract acquisition and negotiation.
Industry Expertise: Minimum of 2 years in the DME/Ancillary Care/Home Healthcare market, with a strong understanding of medical terminology, reimbursement policies, and industry standards.
Communication Skills: Excellent written, verbal, and presentation skills, with strong visual communication abilities.
Self-Motivation: Ability to work independently and as part of a team. Passion for completion and attention to detail.
Confidentiality: Ability to maintain confidentiality when handling sensitive information.
Education: Bachelors degree preferred but not required.
Beacon Hill is an Equal Opportunity Employer that values the strength diversity brings to the workplace. Individuals with Disabilities and Protected Veterans are encouraged to apply.
California residents: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
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