Payer Contract Modeler

Duration: Contract until end of 2026, possibility of permanent hire or extension Shift: Monday-Friday, 40 Hours (Start time from 7am-9am in your time zone, 8 consecutive hours). Key Responsibilities Load, model, test, and maintain payer contracts and fee schedules within the contract management system, including facility, professional, home care, infusion, and pharmacy services Represent the provider perspective in contract interpretation, modeling, and operational workflows Analyze payer contracts to ensure accurate reimbursement logic, including DRG, APC, per diem, case rate, percent of charge, and fee schedule–based methodologies Support implementation of new payer contracts and amendments, ensuring timely and accurate system setup Model and operationalize risk-based contracting methodologies, value-based arrangements, and global agreements (including transplant agreements where applicable) Validate contract modeling through testing, variance analysis, and reconciliation against expected reimbursement Partner with Revenue Cycle Operations, Managed Care, and Finance to identify reimbursement issues, underpayments, and contract compliance gaps Provide ongoing contract support, troubleshooting, and education to downstream teams (billing, follow-up, AR, and leadership) Assist with contract performance analysis, including identifying trends, risks, and optimization opportunities Maintain documentation of contract terms, modeling assumptions, and system configurations Required Qualifications Bachelor’s degree in Finance, Business, Healthcare Administration, or a related field, or equivalent experience 3+ years of experience in payer contract analysis or modeling representing the provider side of the revenue cycle Strong understanding of healthcare reimbursement and managed care contracting from a provider perspective Hands-on experience with contract management or modeling systems Proven experience interpreting payer contracts and translating contract language into executable reimbursement logic Solid understanding of end-to-end revenue cycle workflows (charging, billing, AR, and reimbursement)