Contract Specialist - Medicare

📋 Description

• • Develop and manage contracts with healthcare providers, including negotiating rates and terms, monitoring compliance, and addressing operational issues.
• • Monitor contract performance using established metrics and communicate results to key stakeholders.
• • Research and analyze federal and state regulatory requirements to ensure compliance with Medicare policies and procedures.
• • Develop and maintain relationships with healthcare providers and other stakeholders to facilitate effective communication and collaboration.
• • Participate in the development and implementation of policies and procedures related to contract management.
• • Ensure timely and accurate payment of claims in alignment with regulatory and contractual obligations.
• • Track key performance metrics related to contract execution and provider performance.
• • Apply knowledge of Medicare policies and federal and state regulatory requirements to guide contract decisions and risk mitigation.
• • Collaborate cross-functionally with internal teams to align contract terms with operational and compliance goals.
• • Maintain accurate documentation of all contract negotiations, amendments, and compliance activities.
• • Identify potential contractual risks and propose solutions to ensure adherence to Medicare guidelines.
• • Support the organization’s role as a top Field Marketing Organization (FMO) by upholding industry-leading contract standards.
• • Work remotely as a fully distributed team member serving customers across the United States.
• • Contribute to the growth of a national insurance brokerage firm ranked among the top 20 in the U.S.
• • Engage with healthcare companies, medical providers, and community organizations to strengthen contractual partnerships.
• • Utilize strong analytical, communication, and negotiation skills to resolve contract-related issues and drive favorable outcomes.
• • Demonstrate attention to detail in managing complex, high-volume contract portfolios under strict regulatory oversight.
• • Work collaboratively with team members to ensure consistent application of contract management best practices.
• • Maintain familiarity with evolving federal and state regulatory landscapes affecting Medicare contracts.
• • Support the company’s mission of serving two million customers nationwide through precise and compliant contract administration.