Reimbursement Contract Manager

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Reimbursement Contract Manager based in the United States.

This role plays a critical part in supporting specialty pharmacy and infusion reimbursement operations by ensuring payer contracts are accurately interpreted, implemented, and optimized. The position sits at the intersection of reimbursement strategy, contract analysis, and payer relations, helping ensure compliance while maximizing revenue performance. It involves close collaboration with intake, reimbursement, and managed markets teams to resolve contract discrepancies and improve claims outcomes. The role also contributes to payer education, trend analysis, and operational improvements across reimbursement workflows. In addition, it requires strong analytical capability to identify financial risks, contract gaps, and opportunities for improved cash collections. This is a highly impactful position for a reimbursement professional who thrives in a detail-oriented, healthcare-focused environment.

• Review and interpret payer contracts to ensure accurate understanding of reimbursement terms, including billing rules, fee schedules, and payment conditions.
• Identify missing or unfavorable contract provisions and collaborate with managed markets and leadership to resolve gaps and improve contract terms.
• Conduct reimbursement analysis to identify trends, claim denial drivers, and opportunities for improved revenue capture and cost optimization.
• Develop, maintain, and update internal reimbursement and contract reference documentation used by intake and reimbursement teams.
• Provide payer education and guidance to internal teams on reimbursement policies, contract requirements, and industry updates.
• Collaborate with payer/provider relations teams to resolve contract disputes, claim issues, and non-compliance trends.
• Present analytical findings and reimbursement insights to senior leadership, including VP-level stakeholders and finance executives.
• Support cross-functional discussions on payer strategy, reimbursement performance, and industry best practices.
• Contribute to process improvement initiatives aimed at strengthening reimbursement accuracy and operational efficiency.
• Perform additional duties related to reimbursement analysis, contract management, and revenue cycle support as needed.

Requirements:

• Bachelor’s degree preferred, or 5+ years of experience in reimbursement, account management, or revenue cycle roles involving specialty pharmacy, infusion therapy, or medical device reimbursement.
• Strong experience working with Medicare, Medicaid, and/or managed care reimbursement systems and payer-provider contracting.
• Deep understanding of specialty pharmacy or home infusion reimbursement workflows and billing structures.
• Proven ability to analyze payer contracts, identify financial risks, and interpret complex reimbursement terms.
• Strong analytical, organizational, and problem-solving skills with attention to detail in a regulated healthcare environment.
• Excellent written and verbal communication skills, with the ability to translate complex reimbursement concepts into actionable insights.
• Ability to collaborate effectively with cross-functional teams, including finance, reimbursement, and payer relations.
• Experience identifying trends in claim denials, reimbursement issues, and contract compliance challenges.
• Strong business acumen and ability to support decision-making through data-driven analysis.

Benefits:

• Competitive salary range of $70,000–$88,000 per year
• Comprehensive medical, dental, and vision insurance plans
• 401(k) retirement plan with company match
• Paid time off, paid parental leave, and holiday benefits
• Company-paid life insurance and disability coverage
• Health Savings Account (HSA) and Flexible Spending Account (FSA) options, including dependent care
• Annual merit-based salary increases
• Referral bonus programs and employee recognition initiatives
• Remote-first work structure with standard weekday schedule and limited overtime expectations
• Education assistance and professional development opportunities
• Strong company culture focused on patient impact, innovation, and inclusion