Director - Managed Care - FT Days - MHS
Core
Corporate-level leader executing enterprise-wide strategic and tactical initiatives for complex negotiations with major national and regional payors to drive positive financial trends and achieve appropriate market prices.
Role type
Director, Managed Care Contracting
Builds
Contractual agreements and financial reimbursement models for an integrated healthcare delivery system including acute care, ancillary services, and professional providers.
Domain
Healthcare / Managed Care / Contracting
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Financial analysis and forecasting, contract negotiation, strategic planning, team management, legal and operational contract language expertise, market share growth strategies, payer policy analysis, new business development, operational issue escalation, cross-departmental collaboration
Preferred skills
Local market knowledge, payer and provider experience
Technologies
Financial modeling tools, contract management systems, reporting and analytics platforms
Responsibilities
Enhance, estimate, and preserve net revenues through financial analysis and forecasting; Plan and monitor staff activities including hiring, training, mentoring, and performance evaluation; Execute complex legal, financial, and operational contract language negotiations; Direct and analyze financial performance, reports, quality metrics, and cost savings for payer negotiations; Monitor department operations to meet budget and goals; Respond to insurance industry activities, healthcare reform, and legislative changes; Initiate and research new business opportunities; Escalate and manage operational issues from revenue optimization and accounts receivable management.
Seniority
Director, strategic leadership with hands-on execution
