Responsible for management of the contracting lifecycle from strategy through implementation. Leads negotiations, contract drafting, reimbursement analysis, and network optimization activities for assigned payer relationships.
Works collaboratively with payers, operational leaders, finance, legal counsel, and provider groups to ensure contracts support organizational goals.
Reports To: Vice President, Payer Strategy and Contracting
Key Responsibilities
Contract Lifecycle Management
• Negotiate and manage payer agreements and amendments.
• Draft and review contract language in collaboration with legal counsel.
• Maintain contract inventory and renewal schedules.
• Ensure implementation of negotiated terms.
Financial Analysis
• Evaluate reimbursement methodologies and fee schedules.
• Model financial impact of proposed contract changes.
• Support development of negotiation strategies based on utilization and payment trends.
Network Strategy
• Analyze network participation opportunities.
• Support provider network adequacy discussions.
• Manage payer directory and network-related issues.
Issue Resolution
• Lead contract interpretation discussions.
• Resolve reimbursement disputes and operational contract issues.
• Advocate for organizational interests in payer policy discussions.
Qualifications
• Bachelor's degree required.
• 5-8 years healthcare contracting experience.
• Knowledge of hospital and physician reimbursement methodologies.
• Experience negotiating managed care agreements.
• Strong analytical and project management skills.
