Position Overview
The Managed Care Advisory Specialist at CMS1 Partners plays a central role in guiding provider organizations through the complex landscape of managed care contracting, payer strategy, and network development. You will serve as a trusted advisor to health systems, IPAs, MSOs, and PHOs navigating the evolving dynamics of risk-based payer relationships.
This is a high-impact, client-facing role for a professional with payer-side or provider-side managed care experience who wants to influence outcomes at scale.
Key Responsibilities
- Advise clients on payer contract negotiation strategy across all lines of business
- Conduct fee schedule analysis and rate benchmark comparisons using market data
- Review and interpret contract language, identifying risk provisions, carve-outs, and underpayment clauses
- Support clients through the full contracting cycle from initial outreach through execution
- Develop managed care committee presentations and payer scorecards
- Analyze Medicare Advantage plan performance data and Star Ratings impact on contract terms
- Assist clients in building payer diversification and network alignment strategies
- Stay current on NCQA, CMS, and payer-specific quality and compliance requirements
Qualifications & Requirements
- 4+ years of experience in managed care contracting, payer relations, or health plan operations
- Demonstrated success negotiating contracts with commercial, Medicare Advantage, or Medicaid managed care payers
- Solid understanding of capitation, risk-sharing, fee-for-service, and value-based payment models
- Experience with contract management systems and payer data analytics tools
- Strong negotiation and communication skills
- Healthcare law or compliance background a plus
- Bachelor's degree required; MHA, MBA, or JD preferred
Compensation & Benefits
- Base salary $85,000 – $95,000 based on experience
- Incentive pay tied to contract value delivered for clients
- Full benefits package including health, dental, and vision
- 401(k) retirement plan with employer match
- Remote-first schedule with client travel as needed
- Professional development and certification support
About CMS1 Partners
CMS1 Partners is a nationally recognized healthcare consulting and advisory firm with over 20 years of experience and 12,000+ client engagements. Our team of Six Sigma Black Belts, managed care strategists, and RCM experts partner with health systems, IPAs, MSOs, PHOs, and ACOs to drive financial performance, operational efficiency, and regulatory compliance.
We are proud of our track record — including a 12.7% net revenue increase and $49M in leakage recovery for a single 12-month health system engagement. When you join CMS1 Partners, you join a team that makes a real, measurable difference.