If you’re the kind of person who can juggle payor paperwork, rate analysis, fee schedules, and internal stakeholders without dropping the ball, this role is your lane. You’ll help TridentCare tighten managed care contracts, protect profitability, and keep contract implementation and payment auditing accurate across the business.
About TridentCare
TridentCare supports healthcare organizations with services that rely on clean billing, strong reimbursement strategy, and well-managed payor relationships. This team helps ensure contracts are implemented correctly, reimbursement trends are tracked, and opportunities are pursued strategically.
Schedule
Full-Time
Remote (United States)
Reliable internet access required
What You’ll Do
- Manage the end-to-end managed care contracting process, including proposals/letters of interest and required payor paperwork
- Serve as the primary liaison for assigned “regional” payors
- Maintain electronic copies of signed contracts in compliance with federal, state, and local guidelines
- Outline contract provisions and perform rate impact analysis
- Support the Reimbursement team with non-government payor audits and inquiries
- Review proposals and payor responses with the Sr. Manager for approval
- Partner with System Support to load and test fee schedules and new filing formats for field requirements
- Complete and distribute Health Plan Contracting Announcement Forms to impacted internal teams
- Document contract terms, fee schedules, and billing requirements for managed care payors
- Ensure fee schedules remain current and aligned with contract terms
- Communicate new and amended contract details to internal departments as needed
- Audit contract-related processes to ensure accuracy and optimal performance
- Develop and execute contract documents aligned to annual strategy and company goals
- Build “opportunity” analyses for pricing decisions and in-network vs out-of-network considerations
- Monitor contract profitability and support renegotiation or termination recommendations when needed
- Maintain payor participation listings for billing and sales teams
- Identify payor issues and reimbursement trends that negatively impact collections
- Educate internal teams and external contacts on unique payer requirements
- Proactively pursue payor contracts based on volume, payment trends, collection rates, and sales opportunities
- Act as liaison between Billing A/R and payor relations when contract-related A/R issues escalate
- Handle other duties as assigned
What You Need
- High school diploma (required)
- 3 years of contracting experience
- 4+ years of healthcare billing/accounting experience (required)
- Strong knowledge of managed care and non-government payor relations programs
- Excellent written and verbal communication skills
- Strong attention to detail and goal-driven work style
- Ability to manage multiple deadlines and competing internal/external requests
- Proficiency with Microsoft Office (Excel, Word, PowerPoint, etc.)
- Advanced computer skills
- Experience with contract management software (preferred)
- Typing 35 wpm (preferred)
Benefits
Not listed in the posting. (Ask about benefits, pay range, and performance expectations during the interview process.)
If payor dynamics, fee schedules, and contract accuracy don’t scare you, this could be a solid step up.
Happy Hunting,
~Two Chicks…