[Hiring] Managed Care Contracting Specialist @US Fertility

Role Description

We have an immediate opening for a Managed Care Contracting Specialist to join our remote team at US Fertility .

Schedule: Monday through Friday, 8:00 AM to 5:00 PM

This role provides the opportunity to grow within a nationally respected organization while remaining closely connected to the patients and teams you support every day.

In this role, the Managed Care Contracting Specialist will:

• Negotiate and support new and existing Managed Care agreements, including strategy development, contract language review and redlining, pricing, and operational components across current markets, expansions, and market realignment initiatives.
• Perform full life-cycle contract management, including development, review, execution, and post-implementation monitoring.
• Serve as a key liaison between the organization and payers for contract negotiations, operational issues, and compliance, maintaining strong relationships and effective communication.
• Represent the organization in establishing and maintaining business relationships with payers, providers, and other stakeholders.
• Provide technical support in developing, organizing, processing, and executing contracts; facilitate approval processes from pre-contract through post-signature phases.
• Ensure accurate data entry of contract terms and specifications into contract management systems and maintain completeness of all contracting processes.
• Review, interpret, analyze, and negotiate contract terms; resolve contractual and operational issues in alignment with organizational and regulatory requirements.
• Maintain knowledge of payer policies, reimbursement methodologies (fee-for-service, case rates, and infertility-specific bundled/S-Code arrangements), and applicable federal, state, and local regulations.
• Perform contract modeling and analyze claims data, reimbursement trends, and contract performance to evaluate financial impact, identify risks, and support negotiation strategy.
• Monitor and track contract performance, including financial outcomes, and support ongoing evaluation of payer reimbursement and fee schedules.
• Identify gaps and recommend enhancements to contracts, services, workflows, and operating procedures to improve reimbursement accuracy and operational efficiency.
• Collaborate with cross-functional teams, including revenue cycle, credentialing, operations, and leadership, to support contract implementation and ensure compliance.
• Coordinate and communicate contract terms, medical policy updates, and billing requirements to relevant departments to support accurate execution.
• Assist in resolving payer-related and operational issues, including billing, claims, authorization, credentialing, and noncompliance concerns.
• Support market expansion and new practice integrations by assessing payer coverage, identifying gaps, and providing participation recommendations.
• Maintain reporting on contract status, negotiations, and key initiatives.
• Build and maintain productive working relationships with internal teams, external partners, vendors, and stakeholders.
• Support strategic initiatives and align contracting activities with organizational business goals.
• Participate in internal and external meetings; represent Managed Care in discussions related to contracting and operations.
• Respond to payer, provider, and internal inquiries, providing timely and effective issue resolution.
• Perform additional duties as assigned.

Qualifications

• Bachelor’s degree with 3 to 5 years of relevant experience, or associate degree/equivalent experience with 5–8 years of relevant experience.
• 2 to 5 years of experience in contract negotiations and contract modeling.
• Strong data analytics skills, including advanced proficiency in Excel; experience with NextGen, Power BI, and Rivet is a plus.
• Working knowledge of credentialing and revenue cycle operations as they relate to Managed Care.
• Strong communication skills with the ability to convey information clearly and concisely in a remote, cross-functional environment.
• Excellent interpersonal skills with the ability to build relationships across a multi-disciplinary team.
• Self-starter with the ability to take initiative, work independently, and drive results.
• Strong attention to detail with the ability to manage multiple priorities and meet tight deadlines.
• Positive, customer-centric mindset with a proactive approach to problem-solving and achieving organizational goals.
• Ability to prioritize, multi-task, and adapt in a fast-paced environment.
• Experience with infertility contracting (Preferred).

Benefits

• Medical, dental, and vision insurance.
• 401(k) with company match.
• Tuition assistance and professional development support.
• Performance-based bonus opportunities.
• Generous paid time off, paid holidays, and paid parental leave.
• Life and disability benefits.
• Fertility Discount Program.
• Employee wellness and recognition programs.