Director Managed Care Contracting Jobs (NOW HIRING)

Manager, Managed Care Contracting
Overview
The Manager, Managed Care Contracting reports to the Director of Managed Care and is responsible for the end-to-end contracting lifecycle across hospital, ancillary, physician, ambulatory, and value-based care arrangements. This individual leads the assessment, development, implementation, and ongoing management of complex contractual relationships in support of organizational strategic, financial, operational, and population health objectives. The Manager serves as a key managed care leader, collaborating across Revenue Cycle, Medical Economics, Population Health, Finance, Clinical Operations, Information Technology, and Executive Leadership to optimize reimbursement, evaluate contract performance, and drive payer strategy. Through partnership with data, analytics, and operational stakeholders, this role identifies opportunities to strengthen contract structure, improve financial outcomes, and support both fee-for-service and value-based reimbursement models. This position oversees enterprise managed care contracting activities, ensuring contracts are strategically aligned, operationally executable, and financially sustainable while supporting organizational growth, revenue integrity, and evolving value-based care initiatives.
Responsibilities
Managed Care Contracting

• Manage all aspects of the contracting lifecycle across hospital, ancillary, physician, ambulatory, and other affiliated healthcare entities.
• Evaluate, negotiate, and implement managed care agreements in compliance with organizational policies, reimbursement standards, and regulatory requirements.
• Ensure economically viable contract terms, reimbursement methodologies, and operational provisions.
• Assess and understand the relationship between contract language, reimbursement methodologies, operational workflows, and revenue cycle performance.
• Develop and maintain strategic payer relationships to advance organizational growth, market positioning, and reimbursement objectives.
• Collaborate with Medical Economics to support contract analysis, financial modeling, fee-for-service reimbursement strategies, and value-based initiatives.
• Serve as the primary managed care advisor for revenue cycle, operational, and strategic initiatives across the enterprise.
• Lead negotiations involving complex reimbursement methodologies, including hospital, professional, ambulatory, ancillary, bundled payment, capitation, and risk-based arrangements.

Value-Based Contracting & Population Health

• Support in the development, negotiation, implementation, and ongoing performance management of value-based care arrangements.
• Support organizational strategy related to risk-based reimbursement and value transformation initiatives.

Contract Modeling, Analytics & Revenue Integrity

• Partner with analytical team to lead contract modeling, reimbursement analysis, and financial impact assessments for all managed care negotiations.
• Ensure accurate contract implementation and maintenance within Epic contract management and reimbursement systems.
• Conduct market analyses and benchmarking using internal and external data sources.
• Evaluate reimbursement yield, payment accuracy, underpayments, denials, and payer compliance with contractual obligations.
• Ensure timely updates related to governmental reimbursement methodologies, coding changes, regulatory requirements, and payer policy changes.

Epic & Operational Governance

• Oversee the accurate implementation and maintenance of payer contracts and reimbursement methodologies within Epic.
• Support payer plan governance processes to ensure accurate creation, maintenance, mapping, and deactivation of payer plans.
• Develop and maintain policies, procedures, standards, and controls related to contract implementation and management.
• Lead initiatives to resolve contract-related operational issues impacting reimbursement, patient access, claims adjudication, and revenue integrity.

Strategic Leadership

• Serve as the managed care representative on organizational committees focused on reimbursement, operational efficiency, technology assessment, population health, and strategic growth initiatives.
• Monitor industry, payer, regulatory, and reimbursement trends and recommend strategic responses.
• Assess payer policies and reimbursement changes to identify financial and operational impacts.
• Lead efforts to address significant payer issues including denials, underpayments, policy changes, and contract compliance concerns.
• Provide presentations and recommendations to senior leadership regarding payer strategy, reimbursement performance, contract opportunities, and emerging risks.
• Supervise and provide guidance to team members responsible for contract implementation, modeling, analytics, and related managed care functions.
• Proactively escalate and manage risks, issues, and strategic decisions impacting managed care operations and financial performance.

Qualifications
Education

• Bachelor's degree in Healthcare Administration, Business Administration, Public Health, Finance, Mathematics, Healthcare Informatics, or related field required.
• Master's degree in Business Administration, Health Administration, Public Health, Finance, or related discipline strongly preferred.

Experience

• Five to seven years of progressively responsible managed care contracting, healthcare finance, reimbursement, or revenue cycle experience in a complex healthcare environment.
• Demonstrated experience negotiating and managing hospital, ancillary, physician, ambulatory, and value-based reimbursement arrangements.
• Minimum three years of project leadership or management experience involving healthcare operations, finance, revenue cycle, information technology, or system implementations.
• Experience leading cross-functional initiatives and influencing stakeholders across multiple business areas.

Knowledge & Skills

• Extensive knowledge of managed care reimbursement methodologies, including fee-for-service, DRG, APC, per diem, case rates, CPT-based reimbursement, bundles, capitation, shared savings, shared risk, and pay-for-performance models.
• Strong understanding of value-based care principles, population health management, quality measurement, and alternative payment models.
• Advanced financial modeling, contract analysis, and reimbursement forecasting capabilities.
• Knowledge of physician and hospital reimbursement methodologies, including DRGs, APCs, CPT coding, RVUs, and alternative payment structures.
• Strong communication, negotiation, presentation, and relationship management skills.
• Highly organized with strong analytical and problem-solving abilities.
• Advanced proficiency in Microsoft Excel and business intelligence tools, including financial modeling, dashboards, complex formulas, and data analysis.

Qualifications
Preferred:
EPIC Resolute Hospital Billing Expected Reimbursement
Epic Resolute Professional Billing Expected Reimbursement
About Us
At Atlantic Health, our promise to our communities is; Anyone who enters one of our facilities will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 22,000 team members. Headquarters in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:

• Atlantic Health Morristown Medical Center, Morristown, NJ
• Atlantic Health Overlook Medical Center, Summit, NJ
• Atlantic Health Newton Medical Center, Newton, NJ
• Atlantic Health Chilton Medical Center, Pompton Plains, NJ
• Atlantic Health Hackettstown Medical Center, Hackettstown, NJ
• Atlantic Health Goryeb Children's Hospital, Morristown, NJ
• Atlantic Health CentraState Healthcare System, Freehold, NJ
• Atlantic Medical Group
• Atlantic Visiting Nurse
• Atlantic Mobile Health
• Atlantic Rehabilitation

We have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group.
We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades:

• Chosen for 17 years by Fortune as one of the magazine's "100 Best Companies to Work For."
• Atlantic Health Morristown and Atlantic Health Overlook Named by Newsweek as two of the "World's Best Hospitals" in 2026.
• Atlantic Health Morristown and Atlantic Health Overlook ranked within the top three hospitals in New Jersey by U.S. News & World Report's 2025-2026 Best Hospital rankings.
• Atlantic Health scored four "A" grades by The Leapfrog Group in its Fall 2025 Hospital Safety Grades, performance measures reflecting errors, accidents, injuries and injections, as well as systems hospitals have in place to prevent harm.
• Atlantic Health Morristown and Atlantic Health Overlook are New Jersey's only hospitals to be named among America's 50 Best hospitals by Healthgrades in 2026.
• Named by Becker's Healthcare as one of the "165 Top Places to Work in Healthcare - 2026.
• Atlantic Health Morristown, Atlantic Health Overlook, Atlantic Health Chilton and Atlantic Health Newton all Forbes Top Hospitals for 2026.
• Named by Newsweek as one of America's Greatest Workplaces for Inclusion & Diversity 2025.
• Atlantic Health rated LEVEL 9 - 2025 CHIME Digital Health Most Wired.

Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted:
Team Member Benefits

• Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)
• Life & AD&D Insurance.
• Short-Term and Long-Term Disability (with options to supplement)
• 403(b) Retirement Plan: Employer match, additional non-elective contribution
• PTO & Paid Sick Leave
• Tuition Assistance, Advancement & Academic Advising
• Parental, Adoption, Surrogacy Leave
• Backup and On-Site Childcare
• Well-Being Rewards
• Employee Assistance Program (EAP)
• Fertility Benefits, Healthy Pregnancy Program
• Flexible Spending & Commuter Accounts
• Pet, Home & Auto, Identity Theft and Legal Insurance

Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.
EEO STATEMENT
Atlantic Health, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran
About the Team
Atlantic Health System is at the forefront of medicine, setting standards for quality health care powered by a workforce of more than 18,000 team members and 4,800 affiliated physicians dedicated to building healthier communities, the system offers more than 400 sites of care, including eight award-winning medical centers. Specializing in cardiovascular care, cancer care, orthopedics, neuroscience, pediatrics, women's health and rehabilitation medicine. Atlantic Medical Group, comprised of 1,000 physicians and advanced practice providers, represents one of the largest multi-specialty practices in New Jersey and includes finance, legal, marketing, human resources, talent acquisition, ISS and more. Caring for our patients, our team members and the communities we serve is our central mission.