OverviewHow You Will Make an ImpactThe
Director, Managed Care Contracting is a key leadership role within the Payor Relations team, driving end-to-end contracting strategy, execution, and team oversight in a fast-paced environment. In this role, you will manage contracting professionals while directly overseeing a portfolio of high value managed care agreements across assigned territories or on a national level. By combining strategic negotiation, leadership, financial analysis, and rigorous contract life-cycle management, you will optimize reimbursement, mitigate risks, and enhance operational efficiency to support organizational growth.
ResponsibilitiesWhat You Will Do- Contract Negotiation & Lifecycle Management
- Conduct contract management for a portfolio of complex, high-value managed care agreements, including contract analysis, rate negotiation, language interpretation and negotiation, implementation, and post-signature execution.
- Work directly with the Director of Payor Strategy and Vice-President, Payor Relations & RCM partners to review payor fee schedule terms and structures, negotiate agreement terms, pricing structures, and fee schedules with payors to ensure alignment with financial parameters and strategic business goals.
- Evaluate network adequacy and identify market expansion opportunities; research new territories, conduct gap analyses, and make strategic recommendations regarding participation or non-participation.
- Facilitate approval processes across pre-contract and post-signature phases, liaising with legal, executive leadership, and internal stakeholders as necessary.
Operational Oversight & Internal Collaboration- Partner closely with internal departments, including RCM, Credentialing, and Operations to communicate contractual updates, fee schedule changes, and payor policy adjustments.
- Serve as the primary subject matter expert on managed care contract language, fee schedules, and administrative terms; translate complex contractual clauses into actionable guidelines for operational teams.
- Oversee the organization's contract repository platform (ContractWorks), ensuring the Contract Administrator maintains high data integrity, standardizes tracking protocols, and configures automated alerts for critical milestones such as rate adjustments, renewal options, and termination notice windows.
- Assist in resolving systemic operational friction regarding billing, claims payment, scheduling, registration, and credentialing tied to payor contract terms.
Market Expansion & Network Strategy- Lead payer landscape research for new practice integrations and market expansions, conducting gap analyses against our existing network footprint to deliver data-driven recommendations on payer participation, contract alignment, or strategic non-participation.
Payor & Stakeholder Relations- Represent the organization in cultivating, maintaining, and strengthening professional relationships with health plans, third-party payors, employers, and external partners.
- Conduct regular outreach and meetings with payor representatives to resolve escalated administrative issues, negotiate terms, and drive alignment on shared objectives.
- Develop, maintain, and present comprehensive periodic status reports and operational analyses for leadership, highlighting contract pipeline progress, payer yield, renegotiation timelines, and strategic risks or opportunities.
Team Leadership - Directly supervise, mentor, and develop Contract Manager(s) and Contract Administrator(s), set performance expectations, drive accountability, and guide daily workflows.
- Guide daily contract administration tasks-establishing standard operating procedures (SOPs) for contract intake, data entry accuracy, tracking, and execution workflows.
- Resource Management & Team Growth: Assess team bandwidth, optimize task delegation, and invest in ongoing skill development to build a high-performing contract support function.
Qualifications- 5-10 years of direct managed care contracting experience within a physician group, clinic network, or payor organization; fertility experience preferred.
- Proven track record of managing and negotiating complex physician group and ancillary provider contracts.
- Demonstrated experience in people management with a strong ability to direct, coach, and elevate direct reports.
- Preferred: experience with a Fertility Benefit Manager or Fertility Provider Network
Here's a look at what we offer:Medical, dental, and vision plans, fertility benefits, and supplemental insurance options.
Vacation, personal days, and paid holidays to help you recharge.
- Financial & Retirement Planning
401(k) with employer contribution, plus Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs).
Short- and long-term disability, paid parental leave, basic life insurance, and optional additional coverage.
Employee Assistance Program, commuter benefits, pet insurance, and identity theft protection.
Opportunities and resources to support your career growth.
