Job SummaryThe Contracts Manager will support the full lifecycle of payer agreements, including contract evaluation, negotiation, implementation, maintenance, and performance monitoring. This individual will partner closely with Payer Strategy, Revenue Cycle, Finance, Legal, Operations, Credentialing, and Business Development to ensure contracts are financially sustainable, operationally executable, and aligned with Infusion for Health's growth strategy.
This is a remote position based in California, with minimal travel required throughout the state.Responsibilities- Manage the full lifecycle of payer, IPA, and medical group contracts, including initial review, negotiation, execution, implementation, renewal, amendment, and termination.
- Develop and maintain productive relationships with California IPAs, medical groups, health plans, and other payer partners.
- Evaluate reimbursement rates, fee schedules, contract language, and financial terms to assess the overall value and viability of agreements.
- Negotiate reimbursement and contractual terms with commercial health plans, Medicare Advantage plans, Medicaid managed care organizations, IPAs, and delegated medical groups.
- Review and interpret California IPA agreements, including provisions related to delegated risk, divisions of financial responsibility, authorization requirements, claims submission, reimbursement, and dispute resolution.
- Develop contract analyses, reimbursement comparisons, and financial models to support negotiation strategies and leadership decisions.
- Coordinate with Revenue Cycle, Finance, Operations, Credentialing, and other internal partners to ensure new and amended contracts are implemented accurately and on time.
- Translate contract requirements into clear workflows, system configurations, and operational guidance for internal teams.
- Maintain a centralized repository of payer and IPA contracts, amendments, fee schedules, renewal dates, notice requirements, and other key provisions.
- Monitor contract performance and investigate discrepancies between contracted terms and actual reimbursement.
- Support the resolution of issues involving underpayments, denials, authorization requirements, eligibility, claims routing, reimbursement, and contract interpretation.
- Monitor California managed care and payer trends that could affect reimbursement, network participation, or the company's growth strategy.
- Support contracting activities related to new markets, new service lines, and new infusion center openings.
- Create scalable contracting processes, tools, and reporting practices for a growing organization.
Qualifications:
- Bachelor's degree in healthcare administration, business, finance, or a related field required; advanced degree preferred.
- Five or more years of experience in managed care contracting, payer relations, network development, reimbursement, or a related healthcare function.
- Direct experience negotiating and managing contracts with California IPAs and delegated medical groups is required.
- Established knowledge of California managed care landscape and common IPA contracting structures.
- Strong understanding of delegated arrangements, divisions of financial responsibility, risk-based and fee-for-service reimbursement, authorization requirements, claims processes, and dispute-resolution provisions.
- Experience negotiating and administering agreements with commercial and government-sponsored health plans.
- Strong understanding of healthcare reimbursement methodologies, fee schedules, contract structures, and managed care terminology.
- Strong project-management skills and the ability to manage multiple contracts, deadlines, and competing priorities.
- Experience in infusion therapy, specialty pharmacy, ambulatory healthcare, or another specialty provider environment is strongly preferred.
- Experience supporting payer contracting across multiple states is preferred.
Compensation:
- Base Salary: $150,000 - $165,000
Join us as we strengthen our contractual foundation to better serve our patients through innovative partnerships and compliant procurement practice
