Managed Care Contracts Director

Responsibilities

• Strategic - Develops and implements system-wide Managed Care strategy using advanced analytics and AI-driven tools.
• Strategic - Works closely with senior leadership to enhance contract negotiations and modeling, predict outcomes, and assess policy impacts.
• Operational - Manages day-to-day management of a portfolio of payer contracts worth $500 million to more than $2 billion annually.
• Operational - Utilizes AI-enabled platforms to centralize payer-provider agreements, automate contract data extraction, and improve workflow efficiency.
• Operational - Ensures contractual rate increases occur on time and accurately for all entities.
• Operational - Analyzes and quantifies material adverse payer policy changes and develops strategies to mitigate their impact.
• Leading People - Leads people toward meeting the organization's vision, mission, and goals.
• Leading People - Provides ongoing feedback and opportunities for learning to foster and mentor the development of others.
• Leading People - Manages and resolves conflicts and disagreements in a constructive manner.
• Results Driven - Makes decisions that produce high-quality results by applying technical knowledge, analyzing problems, and calculating risks.

Qualifications

• Education - Bachelor’s degree in business administration, health administration, or a related field. Master's degree in Health Administration (MHA) or Business Administration (MBA) focusing on healthcare or a related field preferred.
• Experience - At least 7 years of progressive experience in managed care contracting within a healthcare provider or payer organization. At least 5 years of leadership experience in a similar role.
• Knowledge/Skills - Deep understanding of various managed care models, financial modeling, contract profitability analysis, and forecasting the financial implications of different contract terms. Exceptional negotiation skills, proficiency in Microsoft Office tools, and strong analytical and communication skills.