MCO Contracting Specialist

Description Build What Matters Most—Families, Futures, and Your Career Enjoy meaningful work while contributing to an organization that changes lives every day. US Fertility , the nation’s leading partnership of physician-led fertility practices, is redefining what it means to build a career in reproductive medicine. Our team members choose to build their career home at US Fertility because of the hope we inspire in our patients , the lives we help bring into the world , and the culture of excellence we foster across our organization . We share a deep commitment to continuously improving the patient experience and advancing research and development in one of the most dynamic and impactful fields of medicine. Through our national network of premier fertility centers we combine clinical expertise, scientific innovation, and compassionate care. The work we do building families offers purpose, challenge, and personal reward—and we’re just getting started. Opportunity Overview We have an immediate opening for a Managed Care Contracting Specialist to join our remote team at US Fertility . Schedule: Monday through Friday, 8:00 AM to 5:00 PM This role provides the opportunity to grow within a nationally respected organization while remaining closely connected to the patients and teams you support every day. How You’ll Contribute At US Fertility, collaboration is fundamental to how we work. There is undeniable strength in numbers—and support is always within reach. Whether collaborating with more than 200 highly respected physicians nationwide or partnering with colleagues who are passionate about solving meaningful problems, you’ll be surrounded by a team committed to shared success. In this role, the Managed Care Contracting Specialist will: Negotiate and support new and existing Managed Care agreements, including strategy development, contract language review and redlining, pricing, and operational components across current markets, expansions, and market realignment initiatives Perform full life-cycle contract management, including development, review, execution, and post-implementation monitoring Serve as a key liaison between the organization and payers for contract negotiations, operational issues, and compliance, maintaining strong relationships and effective communication Represent the organization in establishing and maintaining business relationships with payers, providers, and other stakeholders Provide technical support in developing, organizing, processing, and executing contracts; facilitate approval processes from pre-contract through post-signature phases Ensure accurate data entry of contract terms and specifications into contract management systems and maintain completeness of all contracting processes Review, interpret, analyze, and negotiate contract terms; resolve contractual and operational issues in alignment with organizational and regulatory requirements Maintain knowledge of payer policies, reimbursement methodologies (fee-for-service, case rates, and infertility-specific bundled/S-Code arrangements), and applicable federal, state, and local regulations Perform contract modeling and analyze claims data, reimbursement trends, and contract performance to evaluate financial impact, identify risks, and support negotiation strategy Monitor and track contract performance, including financial outcomes, and support ongoing evaluation of payer reimbursement and fee schedules Identify gaps and recommend enhancements to contracts, services, workflows, and operating procedures to improve reimbursement accuracy and operational efficiency Collaborate with cross-functional teams, including revenue cycle, credentialing, operations, and leadership, to support contract implementation and ensure compliance Coordinate and communicate contract terms, medical policy updates, and billing requirements to relevant departments to support accurate execution Assist in resolving payer-related and operational issues, including billing, claims, authorization, credentialing, and noncompliance concerns Support market expansion and new practice integrations by assessing payer coverage, identifying gaps, and providing participation recommendations Maintain reporting on contract status, negotiations, and key initiatives Build and maintain productive working relationships with internal teams, external partners, vendors, and stakeholders Support strategic initiatives and align contracting activities with organizational business goals Participate in internal and external meetings; represent Managed Care in discussions related to contracting and operations Respond to payer, provider, and internal inquiries, providing timely and effective issue resolution Perform additional duties as assigned What You’ll Bring We’re looking for professionals who bring both technical skill and a deep sense of responsibility to the care experience—individuals who thrive in environments where excellence, empathy, and accountability matter. Qualifications and Skills Include: Bachelor’s degree with 3 to 5 years of relevant experience, or associate degree / equivalent experience with 5–8 years of relevant experience 2 to 5 years of experience in contract negotiations and contract modeling Strong data analytics skills, including advanced proficiency in Excel; experience with NextGen, Power BI, and Rivet is a plus Working knowledge of credentialing and revenue cycle operations as they relate to Managed Care Strong communication skills with the ability to convey information clearly and concisely in a remote, cross-functional environment Excellent interpersonal skills with the ability to build relationships across a multi-disciplinary team Self-starter with the ability to take initiative, work independently, and drive results Strong attention to detail with the ability to manage multiple priorities and meet tight deadlines Positive, customer-centric mindset with a proactive approach to problem-solving and achieving organizational goals Ability to prioritize, multi-task, and adapt in a fast-paced environment Experience with infertility contracting (Preferred) More important than any single credential, however, is the right person . Team members who are most successful at US Fertility embrace our mission, live our values, and remain committed to continuous improvement—for themselves, their colleagues, and the patients we serve. What We Offer US Fertility is proud to provide a competitive, comprehensive benefits package designed to support our team members—professionally and personally—across all employment types. Full-Time Employees (30+ hours/week) Medical, dental, and vision insurance 401(k) with company match Tuition assistance and professional development support Performance-based bonus opportunities Generous paid time off, paid holidays, and paid parental leave Life and disability benefits Fertility Discount Program Employee wellness and recognition programs Part-Time Employees 401(k) with company match Performance-based bonus opportunities Employee wellness and recognition programs Per Diem Employees 401(k) with company match Employee wellness and recognition programs Our Commitment to Inclusion and Opportunity US Fertility and its network partners believe that a diverse workforce is essential to fulfilling our mission of expanding patient access to the highest standards of fertility care. We are committed to equitable and inclusive hiring practices that ensure our clinical and operational teams reflect and support the diverse communities and patients we serve. Across our national footprint, US Fertility is a leader in offering clinical, administrative, and operational career opportunities at locations throughout the United States. We are equally committed to developing individual strengths, promoting from within, and supporting long-term career growth. This is a moment of growth, innovation, and impact. Take the next step in your career with US Fertility—and help shape the future of fertility care.