Managed Care Senior Manager - FT - Days - MHS
Core
Senior manager responsible for deploying strategic and tactical initiatives for negotiations with national and regional payors to drive positive financial trends and achieve appropriate market price points for a fully integrated healthcare delivery system.
Role type
Senior Managed Care Manager (Healthcare Contracting)
Builds
Contractual agreements and financial reimbursement models for acute care, ancillary, and professional providers
Domain
Healthcare / Managed Care Contracting
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Contract negotiation, financial analysis and forecasting, contract language interpretation, managed care industry knowledge, team leadership and mentoring, revenue optimization, regulatory compliance understanding
Preferred skills
Experience with value-based arrangements (capitation, bundled payments, pay for performance), dispute resolution, market share strategy
Technologies
Contract management systems, financial modeling tools, claims reconciliation platforms
Responsibilities
Execute complex legal, financial, and operational contract language negotiations with payors; Plan and monitor staff activities including hiring, training, and performance evaluation; Analyze financial performance, quality metrics, and cost savings for negotiations; Interface with managed care plans on claim reconciliations and operational projects; Research new business opportunities and respond to healthcare reform and legislative changes; Monitor department operations to meet budget and goals
Seniority
Senior, hands-on IC with strategic oversight
