Position Overview:

The Manager of Contract Load Integrity & Payer Creation is responsible for overseeing the auditing of contract loads performed by Managed Care. This role ensures payer contracts are configured correctly to support clean claims, accurate reimbursement, and strong financial controls across the largest ASC network in the United States. The position partners closely with Managed Care, Billing, Reimbursement, and Compliance teams to support revenue integrity, SOX compliance, and payer performance optimization. This role is expected to provide both strategic oversight and hands-on leadership for contract configuration and compliance workflows, while supporting audit readiness and cross-functional alignment. 

Responsibilities:

• Oversee the auditing of payer contracts loaded by the Managed Care team to ensure accurate and timely adjustments.
• Ensure contract terms, rates, methodologies, and effective dates are accurately reflected and aligned with managed care agreements.
• Establish standardized contract load audit controls, documentation, and validation processes to ensure consistency across the CBO.
• Partner with Payer Reimbursement leadership to ensure contract configuration supports accurate expected reimbursement and variance analysis.
• Serve as the primary operational owner for SOX-related controls tied to payer contracts and reimbursement configuration.
• Coordinate and oversee SOX audits related to contract loading, access controls, and change management.
• Ensure SOX Audit testing documentation, evidence, and remediation plans are complete and timely.
• Act as a key liaison between the CBO, Managed Care, and Revenue Cycle teams to ensure contract intent is operationalized correctly.
• Manage the initial set-up and maintenance of insurance carriers loads into all PAS systems supported by the CBO.
• Support Managed Care initiatives by translating contract language into operational workflows and system configuration requirements.
• Support training, documentation, and escalation pathways for contract-related issues.
• Identify gaps, risks, or inefficiencies in contract loading, audit readiness, or payer configuration processes.
• Additional duties as assigned.

Requirements:

• 5+ years of experience in ASC or outpatient revenue cycle, payer reimbursement, or managed care contract administration.
• Strong working knowledge of managed care contracts, reimbursement methodologies, and contract configuration.
• Demonstrated ability to work cross-functionally with billing, managed care, compliance, and IT teams.
• Strong analytical, documentation, and problem-solving skills.
• Advanced proficiency in Microsoft Excel and other Microsoft Office applications.
• Experience with ASC billing and contract management systems (SIS, AdvantX, Vision, Waystar, or similar) preferred.
• Bachelor’s degree, or related field preferred (or equivalent experience).