RCM Contracts Manager

About This Opportunity

We are representing a confidential healthcare organization that operates a comprehensive integrated delivery system serving patients across the United States. Our client is seeking an experienced RCM Contracts Manager to join their revenue cycle management team. This is a critical role for someone who excels at translating complex payer agreements into operational excellence.

As the subject matter expert for payer reimbursement terms and contract interpretation, you'll bridge the gap between contractual obligations and revenue cycle operations. This position offers the opportunity to make a direct impact on billing accuracy, reimbursement optimization, and compliance across home health and durable medical equipment services.

Responsibilities

• Review, analyze, and maintain payer contracts for home health and DME services, interpreting reimbursement methodologies, fee schedules, and billing rules
• Identify operational impacts of payer contract terms and communicate requirements across departments including billing, compliance, and IT teams
• Monitor contract performance and reimbursement trends to identify discrepancies, underpayments, or revenue leakage opportunities
• Collaborate with leadership on contract renewals and payer negotiations by providing operational and financial insights
• Establish and document payer requirements for implementation within company systems, ENS platforms, and billing workflows
• Ensure payer-specific pricing, billing edits, authorization rules, and reimbursement requirements are accurately configured and maintained
• Supervise and support a Contracts Specialist responsible for loading pricing and contractual requirements into company systems
• Oversee testing and validation processes for payer updates, fee schedule changes, and system enhancements
• Serve as a resource to billing, collections, intake, and operational teams regarding contract interpretation and payer requirements
• Ensure payer contract requirements are implemented in compliance with federal, state, and payer regulations
• Develop and maintain standard operating procedures related to payer contract implementation and maintenance

What We're Looking For

• Bachelor's degree in Healthcare Administration, Business, Finance, or related field preferred
• Minimum of 5 years of experience in healthcare revenue cycle, managed care contracting, payer relations, or DME/home health reimbursement
• Strong understanding of home health and DME payer reimbursement methodologies, billing requirements, and revenue cycle operations
• Proven experience interpreting managed care contracts and translating contract terms into operational requirements
• Prior experience managing or supervising staff preferred
• Knowledge of Medicare, Medicaid, commercial insurance, and managed care payer structures
• Experience with healthcare billing systems, fee schedule management, and payer configuration processes
• Strong analytical, organizational, and problem-solving skills with excellent attention to detail
• Excellent communication and cross-functional collaboration abilities
• Comprehensive knowledge of managed care industry and product administration/implementation

How We Work With You

When you apply through Get A Job.ai, our experienced recruitment team will review your qualifications and conduct an initial screening. We'll discuss your background, career goals, and fit for this position. Qualified candidates will then be submitted directly to our client for consideration. Please do not contact the employer directly—all communication and coordination will be managed through our talent team to ensure a smooth and professional process.

Pay

Compensation details will be discussed during the screening process based on experience and qualifications.

Equal Employment Opportunity: Get A Job.ai is committed to creating an inclusive environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.