Manager, Managed Care Contracting & Operations

Primary Job Responsibilities

• Communicate the changing landscape of payor network, pricing, consolidation and payment strategies.
• Suggest strategies for mitigating financial damage to NorthBay in advance of the implementation of these strategies by payors.
• Conduct Payor Contract Negotiations under oversight of leadership.
• Conduct or oversee Subcontract Negotiations.
• Manage or Oversee Operationalization and staff education of managed care contracts and related topics.
• Manage or Oversee Data Collection and Analysis.
• Oversee the management of the claim’s payment function for hospital and medical group claims.
• Manage or Oversee capitation reconciliation and stop loss functions.

About Us

Interpersonal Skills and Values
NorthBay Health’s True North Values: Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence.

Required QUALIFICATIONS

• Bachelor’s degree required.
• Minimum 3 years of experience required in healthcare reimbursement mechanisms and contract negotiations.
• Prior experience in a managed care organization or department required.
• Understands the health insurance market and distribution channels, the healthcare delivery system, referral arrangements and financial principles.
• Capable of thinking strategically as well as tactically; good writing and verbal skills; analytical skills (quantitative and mathematical skills strongly preferred).
• Works and speaks openly with people throughout the organization; an orientation to detail, along with the ability to manage details; ability to meet deadlines and produce accurate work.
• Strong negotiator.

Hours

Based on business need.

Compensation

$130K - $150K plus variable incentive "bonus". Max rate listed is commensurate of 20+ years of experience. Offer is based on years of experience doing the duties of the role.

About NorthBay Health

NorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics. We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions. We are committed to being the trusted healthcare partner of choice and offer an environment where employees can grow, contribute meaningfully, and support the health of our communities.

Benefits Options

NorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability, and long-term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market-based compensation review and increases subject to approval and organizational performance.

Notice to Recruitment Agencies

We do not accept unsolicited resumes or third-party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians, or hiring managers regarding recruitment or job postings.