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Senior Director, Contract Compliance & Performance

The Senior Director, Contract Compliance & Performance is a senior operational and analytical leader responsible for executing the enterprise Contract Compliance & Performance strategy under the direction of the Associate Vice President, Contract Compliance & Performance.

The Senior Director leads the day-to-day monitoring, analysis, validation, and remediation of payer contract performance across the health system, including hospital, ambulatory, physician, and faculty practice operations.

The position translates payer contract requirements into measurable operational controls, reimbursement analytics, monitoring processes, and actionable performance intelligence. The Senior Director is responsible for identifying discrepancies between contracted and actual reimbursement, quantifying financial impact, coordinating root-cause analysis, and driving resolution of contract-performance issues.

Working in close partnership with Managed Care Contracting, Revenue Cycle, Finance, Patient Financial Services, Physician Enterprise, Faculty Practice, Information Technology, Data & Analytics, Compliance, Legal, and operational leadership, the Senior Director ensures that contract-performance issues are identified early, appropriately escalated, and resolved through sustainable corrective and preventive actions.

The Senior Director serves as a key deputy to the AVP and provides leadership for the operational execution and maturation of the Contract Compliance & Performance function.

Strength through Unity and Inclusion

The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai's unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual.

At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next chapter in our history.

About the Mount Sinai Health System:

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients' medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report's "Best Children's Hospitals" ranks Mount Sinai Kravis Children's Hospital among the country's best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 11 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's Best Smart Hospitals" ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.

Equal Opportunity Employer

The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization.

Education Requirements

• Graduate degree in Business or Healthcare Administration. 

Experience Requirements

• 7-10 years of experience in health administration including a minimum of 3 years preferred leadership in a health care setting. 

Department requirements(pending comp approval) 

Education Requirements:

• Bachelor's degree in healthcare administration, finance, business administration, accounting, health information management, data analytics, or a related field.

• Master's degree preferred, including MBA, MHA, MPH, or related advanced degree

Experience Requirements:

•  7 years of progressive experience in healthcare finance, payer contracting, reimbursement, revenue cycle, contract compliance, revenue analytics, or a related field. Strong preference  for candidates with  10 or more years of experience
• Significant experience in payer contract performance, reimbursement analytics, payment validation, or revenue-cycle analytics.
• Experience working within a large academic medical center, integrated delivery network, multi-hospital health system, or similarly complex healthcare organization.
• Experience with both facility and professional reimbursement strongly preferred.
• Demonstrated experience leading complex analytical, operational, or enterprise initiatives.
• Experience partnering with Managed Care, Revenue Cycle, Finance, IT, Compliance, and operational leadership.
• Demonstrated ability to translate contractual and reimbursement requirements into operational processes, analytics, controls, and measurable outcomes.
• Experience leading teams of analysts, managers, or other professional staff.

Preferred Qualifications

• Experience within a major academic medical center or integrated academic health system.
• Experience with commercial, Medicare, Medicaid, and value-based reimbursement arrangements.
• Experience supporting payer negotiations and contract strategy.
• Experience with Epic hospital and professional billing environments.
• Experience with contract modeling, payment validation, or reimbursement analytics technologies.
• Experience developing payer scorecards and executive dashboards.
• Experience with healthcare data warehouses and enterprise analytics platforms.
• Experience using automation, machine learning, or artificial intelligence in healthcare financial analytics.
• Experience with large-scale revenue-cycle transformation.
• Experience establishing enterprise governance and standardized processes.
• HFMA, healthcare finance, revenue-cycle, analytics, or project-management certification.

Knowledge, Skills & Abilities

• Advanced knowledge of healthcare payer reimbursement and contract performance.
• Strong understanding of hospital and professional reimbursement methodologies.
• Knowledge of Medicare, Medicaid, and commercial payer requirements.
• Understanding of DRG, APC, CPT, HCPCS, fee schedule, percentage-of-Medicare, case rates, and other reimbursement methodologies.
• Strong financial and quantitative analysis skills.
• Ability to interpret complex payer contract provisions.
• Ability to translate contractual requirements into operational and analytical requirements.
• Strong understanding of revenue-cycle operations.
• Experience with payment variance and reimbursement analysis.
• Strong data-management and reporting capabilities.
• Ability to develop meaningful dashboards and performance indicators.
• Strong project and process-management skills.
• Excellent written, verbal, and presentation skills.
• Ability to communicate complex analytical findings to executive and operational audiences.
• Demonstrated ability to influence without direct authority.
• Strong problem-solving and root-cause-analysis capabilities.
• Strong organizational and prioritization skills.
• Ability to manage multiple enterprise initiatives simultaneously.
• Strong change-management and process-improvement capabilities.
• Ability to lead and develop high-performing teams.

Key Performance Indicators

Performance should be evaluated using financial, operational, analytical, compliance, and organizational measures.

Financial & Contract Performance

• Contracted versus actual reimbursement accuracy
• Identification of material payment variances
• Financial value of identified opportunities
• Recovery and remediation performance
• Reduction in recurring reimbursement leakage
• Timeliness of financial opportunity identification
• Accuracy of expected reimbursement methodologies

Operational Performance

• Contract implementation timeliness
• Contract implementation accuracy
• Variance investigation turnaround time
• Issue resolution cycle time
• Corrective-action completion
• Sustainability of remediation
• Adoption of standardized monitoring processes

Analytics & Reporting

• Accuracy of contract-performance reporting
• Timeliness of reporting
• Dashboard utilization
• Data-quality performance
• Effectiveness of exception-based monitoring
• Development of new analytical capabilities
• Automation and process-efficiency improvements

Compliance & Risk

• Completion of scheduled monitoring
• Timeliness of risk identification and escalation
• Audit findings and remediation
• Documentation quality
• Resolution of material contract-performance issues
• Compliance with established monitoring standards

Strategic & Organizational Performance

• Quality of support provided to Managed Care and executive leadership
• Cross-functional stakeholder effectiveness
• Advancement of Contract Compliance & Performance maturity
• Team engagement and retention
• Talent development
• Succession readiness
• Achievement of departmental strategic objectives

Certifications

Relevant professional certifications may be preferred, including:

• HFMA Certified Healthcare Financial Professional (CHFP)
• HFMA Certified Revenue Cycle Representative (CRCR)
• Project Management Professional (PMP)
• Other relevant healthcare finance, reimbursement, compliance, analytics, or revenue-cycle certifications

Leadership Competencies

The successful candidate will demonstrate:

• Operational Leadership: Ability to translate enterprise strategy into disciplined execution, measurable outcomes, and sustainable processes.
• Analytical Leadership: Ability to interpret complex reimbursement and contractual data and translate findings into actionable decisions.
• Enterprise Perspective: Ability to understand interdependencies across Revenue Cycle, Managed Care, Finance, IT, Compliance, and clinical and physician operations.
• Executive Communication: Ability to communicate complex issues concisely and effectively to senior leaders.
• Influence & Collaboration: Ability to drive results across a matrixed organization without relying solely on direct authority.
• Accountability: Demonstrated ownership of issues, transparency regarding risks, and commitment to measurable results.
• Problem Solving: Ability to identify root causes and develop practical, sustainable solutions.
• Continuous Improvement: Ability to identify opportunities to improve processes, controls, technology, and analytical capabilities.
• Change Leadership: Ability to implement new processes and operating models in complex environments.
• Talent Development: Ability to recruit, coach, develop, and retain high-performing analytical and operational talent.

Role Scope

The Senior Director, Contract Compliance & Performance is a senior operational leader responsible for executing and advancing the enterprise Contract Compliance & Performance strategy under the direction of the Associate Vice President.

The position serves as a critical link between contractual requirements, reimbursement analytics, payment validation, operational controls, issue remediation, and executive intelligence.<...