Managed Care Contracting and Performance Advisor
Core
Strategic management, evaluation, negotiation, implementation, and ongoing performance monitoring of managed care contracts to optimize reimbursement and mitigate risk.
Role type
Senior Managed Care Contracting and Performance Advisor
Builds
Optimized reimbursement contracts and financial outcomes for hospital and physician service lines
Domain
Healthcare Finance / Managed Care Contracting
Required skills
Managed care contract negotiation, reimbursement analysis, financial modeling, contract compliance, payer relationship management, business case development, contract implementation coordination, performance monitoring, dispute resolution, strategic planning
Preferred skills
Experience with Medicare/Medicaid/DRG/APC/fee schedules, value-based care models, advanced Excel/PowerPoint, project management
Technologies
Microsoft Excel, PowerPoint, healthcare financial analytics tools
Responsibilities
Conduct contract audits and financial modeling to identify reimbursement opportunities; Develop and execute strategic negotiation plans for commercial and government payers; Coordinate implementation of new or amended agreements; Monitor KPIs for reimbursement accuracy and underpayment trends; Prepare executive reports on contract performance and strategic recommendations
Seniority
Senior, hands-on IC