Job Brief1 Opening
Pay Range: DIRECTOR, MANAGED CARE CONTRACTING - $153,628.80 to $245,793.60
Job SummaryThe Director of Managed Care Contracting provides strategic leadership for the hospital's payor contracting and Revenue Integrity functions; driving initiatives that optimize reimbursement, strengthen financial performance, and support long-term strategic objectives. This position oversees the development, negotiation, execution, and ongoing management of managed care agreements in collaboration with the Chief Financial Officer, ensuring contracts align with organizational goals, regulatory requirements, and market dynamics. Leads complex contract negotiations, evaluates payor proposals through financial and operational analysis, and develops strategies that maximize contract value while mitigating risk. Additionally, this position oversees accurate reimbursement, contract compliance, and revenue optimization through effective collaboration with clinical, operational, and finance leaders.
What You'll Bring to the Team:- Required demonstrated knowledge and experience of negotiating and managing payer contracts.
- Required demonstrated knowledge and experience in using Excel (demonstrating advanced usage of formulas and modeling techniques), hospital billing systems, and other financial software systems, including report writing, that supports review and analysis of financial performance by payer.
- Demonstrates ability to communicate both verbally and in writing.
- Demonstrates ability to analyze problematic situations and implement solutions.
- Customer service skills.
- Demonstrates experience and knowledge of principles and practices used in the development of payer contracts, contract administration, and negotiation strategies.
Licensure and Certification:Education:- Bachelor's degree required; preferably in economics, business, finance, or healthcare.
- Preferred Master's degree in healthcare economics, healthcare policy, or finance.
Experience:- Minimum seven (7) years recent employment in a hospital, medical or healthcare insurance field with experience in the negotiation and management of payer contracts and analytics.
- Preferred progressive hospital payer contracting experience, Direct payer negation strategy development, Payer relationship management, Management and supervision of Payer Contract Analyst position
