Contract Manager, Payor Strategy

Care Options for Kids connects leading pediatric specialists with families to provide best-in-class pediatric nursing, therapy and school-based services. We seamlessly integrate into children’s lives by bringing individualized care to children where they live, work, and play. Our pediatric specialists are committed to providing high-quality pediatric services that help children and families live their best lives. We empower our community of clinicians to meet children where they are by providing the support and resources necessary to decrease administrative burdens. This focus allows our clinicians to obtain optimal work-life balance. The Contract Manager will be responsible for negotiating, implementing, and managing payer agreements to support the organization’s clinical operations and financial objectives. This individual will work closely with executive leadership, revenue cycle, operations, and legal partners to ensure payer contracts align with service offerings, regulatory requirements, and reimbursement targets. The ideal candidate brings deep experience in healthcare contracting, strong negotiation skills, and a working understanding of home health, pediatric services, or post-acute care reimbursement models. Key Responsibilities Payer Contracting & Negotiation Lead negotiations with commercial payers, Medicaid managed care organizations, and other payer entities at both regional and national levels Secure new payer contracts and lead contract renewals, amendments, and rate negotiations Analyze reimbursement models, fee schedules, and contract terms to ensure financial sustainability and alignment with organizational goals Support contracting for new market expansion, service lines, and payer participation initiatives Contract Management & Administration Review, interpret, and manage payer agreements, including rates, terms, performance requirements, and termination clauses Maintain organized contract documentation and ensure accurate implementation of contracted terms across operational teams Partner with internal stakeholders to ensure payer contracts are operationally executable and compliant Cross-Functional Collaboration Collaborate with revenue cycle, billing, authorization, and finance teams to address payer requirements, contract interpretation, and reimbursement issues Serve as a subject matter expert for payer contract language, reimbursement methodologies, and escalation support Work with legal, compliance, and leadership teams on contract approvals and risk mitigation Market & Performance Analysis Monitor payer performance, reimbursement trends, and market benchmarks Identify opportunities to improve payer mix, rates, and contract structures Support leadership with contract summaries, financial impact analyses, and executive reporting Qualifications Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or a related field 5 years of experience in healthcare payer contracting, provider contracting, or managed care negotiations Proven experience negotiating commercial and/or Medicaid managed care contracts Strong understanding of healthcare reimbur