Managed Care Manager

Neuronetics, Inc.

1d•Remote

About The Position

The Managed Care Manager supports the organization’s payer strategy and growth by building payer partnerships, negotiating contracts, and improving reimbursement outcomes. The role collaborates with teams across Managed Care, Revenue Cycle, Operations, Finance, and Legal to support provider and service access through strong payer relationships and effective operations. The position covers payer contracting and network management, reimbursement analysis, provider credentialing and enrollment, EDI and payer operations, and strategic projects. The Manager serves as a contact for payer-related issues, supports process improvements and system implementations, monitors regulatory and payer changes, and contributes to reporting and planning led by the Director of Managed Care. The position is remote in the U.S. and reports to the Director of Managed Care.

Requirements

Bachelor's degree in Healthcare Administration, Business, or a related field is preferred.
3–5 years of progressive experience in managed care, payer contracting, healthcare reimbursement, or payer operations.
Strong knowledge of commercial payers, Medicare Advantage plans, Medicaid managed care organizations, government plans, and third-party administrators.
Experience negotiating contracts and managing fee schedules and reimbursement arrangements.
Familiarity with EDI processes, ERA and EFT enrollments, and payer operational workflows.
Working knowledge of medical coding and claims processing, including CPT, HCPCS, and ICD-10.
Strong communication, negotiation, relationship management, and analytical skills.
Proficiency with Microsoft Office and contract management or payer-related systems.
Must be authorized to work for any employer in the United States; the employer cannot sponsor or assume responsibility for employment visa or work authorization.

Nice To Haves

Experience in behavioral health, provider-based contracting, or physician practice managed care operations.
Knowledge of value-based reimbursement models and emerging payer trends.
Experience partnering with Finance, Revenue Cycle, and Legal teams on contract review and reimbursement matters.
Familiarity with provider credentialing and enrollment processes.
Ability to independently manage multiple projects and competing priorities.

Responsibilities

Lead and support payer contracting, including new agreements, renewals, amendments, network expansions, Letters of Agreement, Single Case Agreements, and contract maintenance.
Negotiate reimbursement rates and evaluate fee schedules, contract language, and payer policies.
Manage contract lifecycles and maintain accurate agreement, participation, and payer communication records.
Facilitate payer participation for new providers, locations, and markets in support of organizational growth.
Analyze fee schedules, reimbursement methodologies, and payer policies to identify financial performance opportunities.
Work with Revenue Cycle and Operations to investigate and resolve underpayments, rate discrepancies, and reimbursement issues.
Monitor payer performance and support initiatives to improve reimbursement accuracy and revenue capture.
Support provider credentialing and enrollment, including payer affiliations, roster management, demographic updates, and participation tracking.
Assist with EDI and payer operations, including claims, eligibility, ERA, EFT, clearinghouse enrollments, payer IDs, and connectivity troubleshooting.
Collaborate on provider onboarding and operational implementations affecting payer participation.
Serve as a key contact for payer-related issues and escalations.
Partner with internal stakeholders on system implementations, process improvements, and managed care initiatives.
Track Medicare, Medicaid, commercial payer, and regulatory changes and communicate impacts and recommendations to leadership.
Support departmental reporting, strategic planning, and special projects led by the Director of Managed Care.

Benefits

Health insurance
Dental insurance
Vision insurance
Optional supplemental medical insurance
Health savings and flexible spending accounts
Company-paid life insurance and additional voluntary life insurance
Company-paid short-term and long-term disability insurance
401(k) savings and investment plan with company contribution
Paid time off, including vacation and personal time for non-exempt salaried employees
Flex-PTO for full-time exempt employees
Paid sick leave where applicable and required by state law