About the role
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.
