Director - Reimbursement and Contract Analytics

About the role

The Director of Reimbursement and Contract Analytics leads the contract analytics function supporting MSHS managed care agreements across hospital/facility, physician, and ancillary services. This role oversees the development, validation, and operationalization of contract models, rate sheets, and reimbursement analyses.

Responsibilities

• Lead and oversee the contract analytics function supporting hospital, physician, and ancillary managed care agreements, ensuring alignment with organizational contract management and reimbursement strategy.
• Manage, mentor, and develop a team of contract analysts, including setting priorities, overseeing workload distribution, and ensuring high-quality, timely deliverables.
• Develop, implement, and standardize analytical tools and financial models to support contract modeling, reimbursement analysis, and rate sheet development.
• Oversee scenario modeling and rate sheet development to support payer negotiations and broader reimbursement strategy, including evaluation of proposed and counter-proposed contract terms.
• Ensure accurate creation, validation, and maintenance of finalized rate sheets for internal use and for contract build and implementation.
• Oversee contract implementation workflows, including submission, tracking, and validation of contract builds within contract management systems.
• Manage and monitor contract-related work queues and requests, ensuring timely resolution, appropriate escalation, and adherence to service expectations.
• Ensure integrity and accuracy across a large portfolio of payer contracts, including ongoing updates, version control, and routine maintenance.
• Direct and review ad hoc reimbursement and contract analyses to support business decisions and inform reimbursement strategy.
• Establish and enforce validation and quality assurance protocols to ensure all analyses and contract deliverables meet defined accuracy and quality standards.
• Identify and implement opportunities to improve and streamline modeling, reporting, and contract management processes to enhance efficiency and scalability.
• Partner with contracting, finance, IT, and analytics teams to support contract execution, data alignment, performance monitoring, and reimbursement strategy initiatives.
• Support development and delivery of reporting to track contract performance, key metrics, and financial outcomes.
• Maintain proactive communication with internal stakeholders, ensuring responsiveness, organization, and timely follow-up to keep deliverables on track.
• Develop and maintain standard operating procedures to ensure consistency in methodologies, tools, and documentation across the contract analytics function.
• Provide leadership through coaching, training, and performance management to build a high-performing team and support professional development.
• Manage departmental operations using data-driven problem-solving approaches, ensuring compliance with institutional policies and applicable regulatory requirements.

Qualifications

• BA required, MBA or advanced business degree in related finance or health care discipline preferred.
• Minimum 5 years of experience in managed care contracting, reimbursement, healthcare finance, or contract analytics.
• Demonstrated experience leading or managing analytical teams and workflows.
• Strong experience in financial modeling, reimbursement analysis, and contract analytics within a healthcare environment.
• Advanced Microsoft Excel and PowerPoint skills required; experience with SQL or other data tools preferred.
• Strong written and verbal communication skills.