Contracts and Payor Specialist

NeuroRestorative, a part of the Sevita family, provides rehabilitation services for people of all ages with brain, spinal cord and medically complex injuries, illnesses and other challenges. In a variety of locations and community-based settings, we offer a range of programs, including vocational and therapy programs, day treatments, and specialized services for infants, children, adolescents, Military Service Members and Veterans.Contracts and Payor Specialist100% Remote position - no travelREQUIRED:Two to three years’ experience with healthcare contract negotiations, managed care, and health insuranceAt least one year of experience with commercial contract negotiationsMajor Payor experience with: Aetna, BCBS, Cigna, Workers Comp, etcSUMMARYThe Specialist is responsible for identifying and securing public and private insurance contracts; reviews and organizes existing contracts. Assists with the development of potential relationships with strategic partners and creates measurable business results for various markets.ESSENTIAL JOB FUNCTIONSTo perform this job successfully, an individual must be able to satisfactorily perform each essential function listed below:Contracting and CredentialingWorks in partnership with Operations Leaders and Director of Contracts and Payor Engagement to ensure consistency and secure public and private insurance contracts◦ Analyzes and monitors financial aspects of existing contracts and maintains original documentation of all contracts ◦ Identifies, contacts, and creates relationships with potential payors that result in new contracts and increased funding possibilities for program participants ◦ Conducts rate and contract negotiationsDescribes services provided to potential contract sourcesCommunicates with state directors, and state operating/marketing staff regarding contract specifics. Ensures commitments to participants, family, referral sources and payors are metCommunicates contract executions and requirements to all internal departmentsCompletes contract related credentialing and enrollment application requirements◦ Maintains database of licenses, accreditation forms, financial and organizational information for the purpose of efficient and timely enrollment applicationOversees Single Case Agreement process within the Admissions Teams.

May take lead in difficult single case negotiationFacilitates resolution of contract related issues with billing and collections teamPerforms other related duties and activities as requiredSUPERVISORY RESPONSIBILITIESNoneMinimum Knowledge and Skills required by the Job The requirements listed below are representative of the knowledge, skill, and/or abilities required to perform the job:Education and Experience:Bachelor’s degree in Rehabilitation Administration, Business Administration or related field preferred, and/orThree to five years’ experience with contracts, managed care, and health insurance related industry preferredCertificates, Licenses, and Registrations:None requiredPhysical Requirements:Sedentary work. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.AMERICANS WITH DISABILITIES ACT STATEMENTExternal and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job functions either unaided or with assistance of a reasonable accommodation to be determined on a case by case basis via the interactive process.Sevita is a leading provider of home and community-based specialized health care.

We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face. We’ve made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S.As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.Originally posted on Himalayas