Contract Specialist, Managed Care

nimble•Chesterfield, MO

11d

About The Position

The Contract Specialist implements and maintains Nimble’s managed care contracting strategy in a multi-state environment. The role supports the Managed Care Department and is suited to candidates eager to learn in a fast-paced environment. The specialist manages contract files, negotiates with payers on behalf of healthcare facilities and individual providers, analyzes contract terms and financial impacts, and develops recommendations for provider clients. The position also supports contract implementation, issue resolution, regulatory monitoring, and additional client projects. The role includes participating in departmental training and staff meetings and complying with company policies and procedures.

Requirements

0–2 years of experience; recent graduates are encouraged to apply.
Strong analytical and critical-thinking skills, including the ability to interpret complex data and synthesize client-ready insights.
Excellent communication and presentation skills, including the ability to explain data-driven recommendations to non-technical stakeholders.
Strong organization and attention to detail, with the ability to manage multiple priorities and deadlines in a fast-paced environment.
Proficiency in Excel and financial modeling tools.
A bachelor’s degree in Healthcare Administration, Business, Finance, or a related field is preferred.

Nice To Haves

Familiarity with managed care contracts, reimbursement methodologies, and payer systems.
Experience negotiating externally with payers or serving as a liaison between payers and providers.
A degree in Healthcare Administration or Business is encouraged for recent graduates.

Responsibilities

Manage and maintain accurate files for pending and executed managed care contracts, and provide timely network updates to clients.
Serve as the external negotiator with payers on behalf of healthcare facilities and individual providers, managing outreach, communication, and contracting logistics.
Analyze contract terms, reimbursement structures, and financial impacts using data models and payer data.
Develop actionable recommendations from analysis and present findings to provider clients.
Partner with clients to understand their goals and challenges and tailor negotiation strategies accordingly.
Help resolve billing or contractual issues with insurance carriers, advocating on clients’ behalf.
Evaluate, negotiate, and renegotiate managed care contracts with health plans, hospitals and health systems, IPAs, government programs, and other payers.
Load and validate payer contract terms, rates, and fee schedules in client systems.
Maintain organized documentation and version control for contract files and related payer communications.
Track and interpret regulatory updates, policy changes, and market trends that may affect client reimbursement.
Support client projects, including payer escalations, audits, and strategic network decisions.
Participate in departmental training and staff meetings.
Adhere to company compliance policies and procedures.