Healthcare Contract Lead

Beacon Hill Staffing Group - Oklahoma City, OK

Full-time

Oklahoma City, OK

Administrative and Support Services

About the position

The Healthcare Contract Lead is responsible for acquiring new contracts and maintaining relationships with payer accounts, ensuring high levels of client satisfaction and successful contract resolutions. This role involves developing network management strategies that support market growth, compliance, and enhanced member experience, and requires direct experience with healthcare contracts.

Responsibilities

• 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.
• Analyze contracts to assess viability and provide recommendations on reimbursement and contracting strategies.
• Apply state and federal regulations to negotiate and manage contracts, ensuring compliance with payer requirements.
• Ensure quarterly and annual credentialing requirements are met, maintaining accurate and timely applications.
• Stay up to date with healthcare market trends and growth opportunities in the provider network.
• Ensure contract terms, reimbursement rates, and payer policies are clearly communicated to internal stakeholders and reflected in front- and back-end processes.
• Collaborate with operations teams to identify trends in authorization and claim denials, escalating issues to payer contacts as needed.
• Work closely with cross-functional teams to support the organization's strategic goals and objectives.
• Demonstrate the department's core philosophies: Listen, Learn, and Lead.
• Perform other tasks as assigned by the manager.

Requirements

• In-depth understanding of how payers make decisions regarding CMS codes.
• Minimum of 2 years of experience in contract acquisition and negotiation.
• Minimum of 2 years in the DME/Ancillary Care/Home Healthcare market, with a strong understanding of medical terminology, reimbursement policies, and industry standards.
• Excellent written, verbal, and presentation skills, with strong visual communication abilities.
• Ability to work independently and as part of a team.
• Passion for completion and attention to detail.
• Ability to maintain confidentiality when handling sensitive information.

Nice-to-haves

• Bachelor's degree preferred but not required.