Managed Care Contracting Specialist, Acelis Connected Health
About The Position
The Managed Care Contracting Specialist in Abbott’s Acelis Connected Health Heart Failure business manages and renegotiates contracts for Durable Medical Equipment (DME) suppliers and Independent Diagnostic Testing Facilities (IDTF). The role supports organizational operational and financial objectives by ensuring regulatory compliance, optimizing contract terms, maintaining provider relationships, and overseeing Letters of Agreement (LOAs). Abbott’s Heart Failure business develops solutions to diagnose, monitor, and manage heart failure. This position reviews provider agreements, identifies opportunities to improve costs and services, resolves billing and payment issues with non-contracted providers, and monitors contract performance, reimbursement trends, and regulatory changes. The role provides reporting and strategic insights to leadership.
Requirements
- Associate degree or equivalent, or at least 3 years of experience in managed care, payer relations, or healthcare sales; experience in DME or IDTF is preferred.
- 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 relevant to job functions.
Nice To Haves
- 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.
Responsibilities
- Review, analyze, and renegotiate DME and IDTF contracts to align with organizational goals and market standards.
- Ensure 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.
- Resolve billing and payment issues with non-contracted providers.
- Monitor contract performance, reimbursement trends, and regulatory changes.
- Provide reporting and strategic insights to leadership.
Benefits
- Career development opportunities with an international company.
- Employees may qualify for free medical coverage in the Health Investment Plan (HIP) PPO medical plan in the next calendar year.
- Retirement savings plan with a high employer contribution.
- Tuition reimbursement.
- Freedom 2 Save student debt program.
- FreeU education benefit, an affordable and convenient path to earning a bachelor’s degree.
- Health and wellness benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
