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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in payer contracting, reimbursement methodologies, and healthcare regulations, with a strong focus on optimizing contracts and managing provider relationships. Proficient in negotiation and communication, ensuring compliance and strategic insights for organizational goals.
Highest-signal resume keywords
Payer ContractingReimbursement MethodologiesHealthcare RegulationsNegotiation SkillsCRM and Contract Management Systems
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Contract OptimizationBilling and Payment ResolutionHCPCS CodingDME and IDTF KnowledgeReporting and Strategic Insights
Soft Skills
Communication SkillsRelationship-Building SkillsNegotiation Skills
Tools & Technologies
CRM SystemsContract Management Systems
Industry Keywords
Managed CarePayer RelationsMedicare AdvantageMedicaid MCOsCommercial Payers
About the role
Key responsibilities & impact- Review, analyze, and renegotiate DME and IDTF contracts to align with organizational goals and market standards.
- Ensure all agreements comply with federal, state, and payer regulations.
- Identify opportunities for cost savings and improved service delivery through contract optimization.
- Draft, review, and execute Letters of Agreement (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.
- Manage provider relationships and oversee LOA creation and administration.
Requirements
What you’ll need- Associate degree or equivalent, or 3+ years of experience in managed care, payer relations, or healthcare sales, preferably in DME or IDTF.
- 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.
- Experience with Medicare Advantage, Medicaid MCOs, and commercial payers to obtain LOAs (preferred).
- Familiarity with HCPCS coding and billing practices for DME and diagnostic services (preferred).
- Ability to interpret and explain clinical documentation to payers (preferred).
Benefits
Comp & perks- Career development with an international company where you can grow the career you dream of.
- Free medical coverage in the Health Investment Plan (HIP) PPO medical plan in the next calendar year for qualifying employees.
- Excellent 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 getting a bachelor’s degree.
- Health and wellness benefits.
- Equal employment opportunity and commitment to employee diversity.