[Hiring] Managed Care Contracting Specialist @Abbott

Role Description

The Managed Care Contracting Specialist, Acelis Connected Health is responsible for managing and renegotiating contracts for Durable Medical Equipment (DME) suppliers and Independent Diagnostic Testing Facilities (IDTF). This role ensures compliance with regulatory requirements, optimizes contractual terms, maintains provider relationships, and oversees the creation and administration of Letters of Agreement (LOAs) that support operational and financial objectives.

• Review, analyze, and renegotiate DME and IDTF contracts to align with organizational goals and market standards.
• Ensure all agreements comply with federal, state, and payer regulations.
• Identify opportunities for cost savings and improved service delivery through contract optimization.
• Draft, review, and execute LOAs for special arrangements or exceptions, including resolving billing and payment issues with non-contracted providers.
• Monitor contract performance, reimbursement trends, regulatory changes, and provide reporting and strategic insights to leadership.

Qualifications

• Associate degree or equivalent, or 3+ years of experience in managed care, payer relations, or healthcare sales, preferably in DME or IDTF.
• Strong understanding of payer contracting, reimbursement methodologies, and healthcare regulations.
• Excellent negotiation, communication, and relationship-building skills.
• Proficiency in CRM and contract management systems.
• Ability to attend job-related courses and seminars as required.
• Ability to use office equipment that is relevant to job functions.

Requirements

• Experience working with Medicare Advantage, Medicaid MCOs, and commercial payers to obtain LOAs.
• Familiarity with HCPCS coding and billing practices for DME and diagnostic services.
• Ability to interpret and explain clinical documentation to payers.

Benefits

• Career development with an international company where you can grow the career you dream of.
• Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year.
• An excellent retirement savings plan with a high employer contribution.
• Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree.
• A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune.
• A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists.