Senior Director, Managed Care Contracting

The Senior Director is responsible for leading the Managed Care Contracting team and planning, analyzing, negotiating, and implementing new and renegotiated contracts. Lead payor strategies to ensure optimal contracting and operational performance. Serve as lead corporate liaison for Operations leaders as well as key corporate functional support (Shared Services) areas. 

Provide overall team focus on increasing net revenue through favorable contracts that exceed our costs to provide care, as well as on capturing maximum referral volume from each executed contract and increasing out-of-network volume wherever feasible. Lead Contracting role for clinic acquisition and JV due diligence, and integration processes.

• Lead the managed care team efforts to analyze, negotiate, and implement new and renegotiated contracts for the entire contract portfolio. Develop payor strategies to ensure optimal contracting and operational performance for clinic operations. Work with Operational Leaders (National and Local) and Finance to ensure that there is consensus on priorities and execution.
• Lead liaison for Operations, legal, billing, clinical services, and revenue cycle to ensure that the requirements of a contract are implemented and maintained at all times.
• Key contract management and information systems processes lead. Owner of the Contract Management system and other tools.  Ensure renegotiations, COLAs, and payor notices are timely and within established business rule timetables
• Participate in Business Development and Integration planning and coordination. 
• Supervise Directors of Managed Care Contracting.  Set objectives, review performance, conduct staff professional development, and provide guidance in accordance with department objectives, policies, and procedures.  Facilitate staff recruitment, retention, and onboarding/orientation.

• Bachelor’s Degree required/ Master’s degree or equivalent work experience.
• 10 or more years of demonstrated experience in a managed care setting, acute/post-acute hospital setting, ancillary care, preferably working in the payer/provider contracting, network management or provider relations arenas.
• Extensive knowledge, experience, and expertise in successful Managed Care Contracting negotiations, language, modelling analytics, reimbursement methodologies for acute/post-acute care hospitals, physicians, and ancillary providers.
• Strong analytical and proven business case presentation skills and expertise.
• Collaborates with executives to monitor, manage, review, and achieve optimal results.
• Superior client relationship/ account management and communication skills.
• Able to handle multiple projects and perform independently under tight deadlines with a focus on effective implementation, clear and consistent communication, and follow-up.
• Demonstrated skills in attention to detail, superior project management, implementation, and analytical ability, as well as the proven ability to lead activities using a collaborative and team approach on a national, regional, and local level.