What are the responsibilities and job description for the Contract Manager, Payor Strategy position at careoptionsforkids?
Care Options for Kids connects leading pediatric specialists with families to provide best-in-class pediatric nursing, therapy and school-based services. We seamlessly integrate into children’s lives by bringing individualized care to children where they live, work, and play. Our pediatric specialists are committed to providing high-quality pediatric services that help children and families live their best lives. We empower our community of clinicians to meet children where they are by providing the support and resources necessary to decrease administrative burdens. This focus allows our clinicians to obtain optimal work-life balance.
The Contract Manager will be responsible for negotiating, implementing, and managing payer agreements to support the organization’s clinical operations and financial objectives. This individual will work closely with executive leadership, revenue cycle, operations, and legal partners to ensure payer contracts align with service offerings, regulatory requirements, and reimbursement targets.
The ideal candidate brings deep experience in healthcare contracting, strong negotiation skills, and a working understanding of home health, pediatric services, or post-acute care reimbursement models.
Key Responsibilities
Payer Contracting & Negotiation
Required
Salary Range:
Benefits:
Care Options For Kids is an equal opportunity employer. The Equal Employment Opportunity Policy of Care Options For Kids is to provide a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religion, national origin, gender, sexual orientation, age, marital status or disability. Care Options For Kids hires and promotes individuals solely on the basis of their qualifications for the job to be filled. Care Options For Kids believes that associates should be provided with a working environment which enables each associate to be productive and to work to the best of his or her ability. We do not condone or tolerate an atmosphere of intimidation or harassment based on race, color, religion, national origin, gender, sexual orientation, age, marital status or disability. We expect and require the cooperation of all associates in maintaining a discrimination and harassment-free atmosphere.
*Restrictions Apply
The Contract Manager will be responsible for negotiating, implementing, and managing payer agreements to support the organization’s clinical operations and financial objectives. This individual will work closely with executive leadership, revenue cycle, operations, and legal partners to ensure payer contracts align with service offerings, regulatory requirements, and reimbursement targets.
The ideal candidate brings deep experience in healthcare contracting, strong negotiation skills, and a working understanding of home health, pediatric services, or post-acute care reimbursement models.
Key Responsibilities
Payer Contracting & Negotiation
- Lead negotiations with commercial payers, Medicaid managed care organizations, and other payer entities at both regional and national levels
- Secure new payer contracts and lead contract renewals, amendments, and rate negotiations
- Analyze reimbursement models, fee schedules, and contract terms to ensure financial sustainability and alignment with organizational goals
- Support contracting for new market expansion, service lines, and payer participation initiatives
- Review, interpret, and manage payer agreements, including rates, terms, performance requirements, and termination clauses
- Maintain organized contract documentation and ensure accurate implementation of contracted terms across operational teams
- Partner with internal stakeholders to ensure payer contracts are operationally executable and compliant
- Collaborate with revenue cycle, billing, authorization, and finance teams to address payer requirements, contract interpretation, and reimbursement issues
- Serve as a subject matter expert for payer contract language, reimbursement methodologies, and escalation support
- Work with legal, compliance, and leadership teams on contract approvals and risk mitigation
- Monitor payer performance, reimbursement trends, and market benchmarks
- Identify opportunities to improve payer mix, rates, and contract structures
- Support leadership with contract summaries, financial impact analyses, and executive reporting
Required
- Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or a related field
- 5 years of experience in healthcare payer contracting, provider contracting, or managed care negotiations
- Proven experience negotiating commercial and/or Medicaid managed care contracts
- Strong understanding of healthcare reimbursement methodologies
- Excellent negotiation, communication, and interpersonal skills
- Ability to work independently in a fast-paced, growth-oriented environment
- Experience in home health, pediatric homecare, therapy homecare services.
- Multi-state or national payer contracting experience
- Familiarity with value-based arrangements and alternative payment models
- Experience partnering with revenue cycle or finance teams on reimbursement optimization
Salary Range:
- Full-Time, Remote: $80,000.00 to $100,000.00 annually.
Benefits:
- Paid time off
- Medical, dental, and vision
- 401K
Care Options For Kids is an equal opportunity employer. The Equal Employment Opportunity Policy of Care Options For Kids is to provide a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religion, national origin, gender, sexual orientation, age, marital status or disability. Care Options For Kids hires and promotes individuals solely on the basis of their qualifications for the job to be filled. Care Options For Kids believes that associates should be provided with a working environment which enables each associate to be productive and to work to the best of his or her ability. We do not condone or tolerate an atmosphere of intimidation or harassment based on race, color, religion, national origin, gender, sexual orientation, age, marital status or disability. We expect and require the cooperation of all associates in maintaining a discrimination and harassment-free atmosphere.
*Restrictions Apply
Salary : $80,000 - $100,000