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Insurance Contract Specialist (Telemedicine)

Measured · trymeasured.com
New YorkRemoteMid level3–5 yrsContract
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The job in short

Insurance payor contracting for telemedicine.

ClinicalInsuranceComplianceLegal

Details

Found
23 d ago · posted 2025-04-19
Location as listed
New York, New York, US
Role
Payor Contracting Specialist
Source
The company’s own careers site

Full description

Role Summary As our first Insurance Contract Specialist, you will secure commercial and government payor contracts that allow Measured to bill insurance in priority states, then expand coverage nationwide. You’ll coordinate credentialing, negotiate reimbursement terms, and create the roadmap that turns insurance contracting into a repeatable, scalable process. Key Responsibilities • Payor Strategy & Outreach • Research and prioritize states/payors based on market opportunity, regulatory landscape, and patient demand. • Build relationships with payor network managers and initiate contract discussions. • Contract Negotiation & Execution • Negotiate favorable reimbursement rates, terms, and service‑line coverage for telemedicine. • Drive agreements to signature while safeguarding company economics and compliance. • Credentialing & Compliance • Coordinate provider enrollment, CAQH updates, and state‑specific licensing requirements. • Ensure telehealth operations meet STARK, Anti‑Kickback, HIPAA, and payor policy standards. • Performance Tracking & Reporting • Maintain a live pipeline of payor engagements; track time‑to‑contract and coverage percentage. • Deliver concise weekly updates to leadership on progress, roadblocks, and next steps. • Process & Playbook Development • Document best practices and build scalable templates for future contracting hires. • Recommend process improvements across ops, clinical, finance, and legal teams. Qualifications • Experience: • 3–5 years in provider network development, payor contracting, or revenue‑cycle management—preferably multi‑state and telehealth. • Skills: • Working knowledge of commercial, Medicare, and Medicaid reimbursement models. • Strong negotiation skills with payor reps and legal teams. • Credentialing & CAQH proficiency; familiar with STARK, Anti‑Kickback, HIPAA. • Data‑driven; comfortable building simple coverage models and dashboards. • Attributes: • Builder mentality—comfortable with ambiguity and limited resources. • Clear communicator who can align ops, clinical, and finance stakeholders. • Hustle to hit aggressive timelines without sacrificing contract quality. Why You’ll Love This Role • Own a Growth Lever: Your work directly unlocks new revenue streams and patient access. • Flexible & Remote: Set your schedule (~15–25 hrs/week) while delivering outsized impact. • Upside Potential: Well‑defined bonus structure plus path to full‑time leadership. • Mission‑Driven: Help millions receive affordable metabolic care they can’t access today. About Measured Measured is a cash‑pay telemedicine platform delivering evidence‑based metabolic care (obesity, PCOS, and related chronic conditions) across the United States. We combine AI‑powered workflows, nationwide clinical teams, and consumer‑grade engagement tools to make care affordable, accessible, and personalized. Moving from cash‑only to insurance reimbursement is the next critical step in our growth — and you’ll own that mission.

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