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Director Of Managed Care Jobs (NOW HIRING)

Pennant Services

Managed Care Contracting Manager

Establish, plan, direct and evaluate the implementation of tactical plan(s) that will ensure expansion and support of business operations into managed care relationships and brings consistency of ...

Moffitt Cancer Center

Reporting to the Vice President of Payer Strategies and working in close partnership with the Executive Director of Managed Care, the Executive Director of Strategic Contracting is responsible for ...

Sedgwick Claims Management Services Ltd

$110 - $135/hr

R76583By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 ... The Managed Care Client Services Director (MC CSD) is the primary managed care relationship leader ...

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Director Of Managed Care information

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$94.5K

$134.8K

$208K

How much do director of managed care jobs pay per year?

As of Aug 24, 2026, the average yearly pay for director of managed care in the United States is $134,799.00, according to ZipRecruiter salary data. Most workers in this role earn between $111,500.00 and $146,500.00 per year, depending on experience, location, and employer.

What does a director of managed care do?

A Director of Managed Care oversees an organization's relationships and contracts with health insurance providers and managed care organizations. They are responsible for negotiating rates, ensuring compliance with regulations, and optimizing reimbursement strategies to maximize revenue. This role also involves analyzing healthcare trends, monitoring contract performance, and collaborating with other departments to improve patient access and quality of care. Directors of Managed Care typically work in hospitals, healthcare systems, or large medical practices.

What are the key skills and qualifications needed to thrive as a director of managed care, and why are they important?

To thrive as a Director Of Managed Care, you need a strong background in healthcare administration, contract negotiation, and payer relations, usually supported by a bachelor's or master's degree in health administration or a related field. Familiarity with managed care systems, claims processing software, and regulatory compliance tools like HIPAA is essential. Outstanding leadership, analytical thinking, and interpersonal communication skills set top performers apart in this role. These skills ensure the effective management of provider networks, optimize reimbursement strategies, and maintain compliance in a complex healthcare environment.

How does a director of managed care typically collaborate with clinical and administrative teams to optimize payer contracts?

Directors of Managed Care play a central role in bridging clinical and administrative priorities when negotiating and managing payer contracts. They work closely with clinical leaders to understand care delivery needs and cost structures, ensuring that contract terms support both high-quality patient care and financial sustainability. Regular meetings and cross-functional committees are common, where the Director facilitates communication between finance, legal, and clinical teams to align contract strategies with organizational goals. This collaborative approach helps identify opportunities for value-based reimbursement and process improvements.

What is the difference between Director Of Managed Care vs Managed Care Coordinator?

AspectDirector Of Managed CareManaged Care Coordinator
CredentialsBachelor's degree, often advanced certifications in healthcare managementTypically an associate or bachelor's degree, relevant healthcare certifications
Work EnvironmentExecutive setting, overseeing departments, strategic planningClinical or administrative setting, coordinating care plans
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance providers, healthcare facilities, managed care organizations
Primary FocusDeveloping policies, managing teams, strategic oversightImplementing care plans, coordinating patient services

The main difference is that the Director Of Managed Care focuses on strategic leadership and policy development within managed care organizations, while the Managed Care Coordinator handles day-to-day care coordination and patient services. Both roles require healthcare knowledge but differ in scope and responsibilities.

More about Director Of Managed Care jobs

What cities are hiring for Director Of Managed Care jobs?

Cities with the most Director Of Managed Care job openings:

What are the most commonly searched types of Of Managed Care jobs?

The most popular types of Of Managed Care jobs are:

What states have the most Director Of Managed Care jobs?

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Director Of Managed Care jobs near you
Infographic showing various Director Of Managed Care job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 68% Full Time, 22% Part Time, and 8% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $134,799 per year, or $64.8 per hour.

Managed Care Contractor

Lurie Children's Hospital of Chicago

Chicago, IL

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 10 days ago

Job description

Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children's Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

Location

680 Lake Shore Drive

Job Description

Reports to the Director of Managed Care Contracting. Core responsibilities are the negotiation of Single Case Agreements (SCA) for Transplants, General/Surgical Medicine, as well as hospital ancillary agreements. Contractor shall assist/lead transplant contract negotiations, validate profit/loss values by Payor, as well as assist Transplant Team in completion of Report for Information (RFI) requirements/requests. Another key focus of this position will be negotiating/managing/tracking all requests for single case agreements for Out of State Medicaid (OOS) and non-contracted HMO payers. Secondary responsibility is to assist Director of Managed Care Contracting with tracking/evaluating SCAs and Transplant Agreements, monitor outcome & contract performance, validation of accurate and timely billing/reimbursement per SCA/other contract. Establish a process for monitoring timelines and contract terms to eliminate retrospective requests for SCA with non-contracted payers. Assist Director of Managed Care Contracting with Commercial payers, Marketplace Exchange and IPA/PHO/CIN groups.

Essential Job Functions:

  • Oversight and control of factors creating financial loss and liability related to OOS Medicaid and non-contracted HMO members seeking access to care.
  • Become the primary and immediate contact point for all Lurie Children's employees regarding OOS Medicaid and non-contracted HMO members seeking or receiving access to care within the Lurie Children's facility.

    Provide education/in-services on OON process as needed

    Validate that accurate & complete information is provided during the OON Process

  • Serve as the main contact for Payor negotiations with OOS Medicaid payors, non-contracted HMOs and Marketplace Payors.
  • Develop a data base of historical, out of state Medicaid transplant events/encounters: States, payor names, challenges (Credentialing, numbers of LOAs needed for single admissions, trackable payments due against actual received, etc.)
  • Assist in negotiating contracts for HMO IPA groups and other entities/specialties as requested by Leadership (behavioral health, surgical centers, therapy centers, etc.)Collaborate with Patient Financial Services (PFS) to:

    Work directly with designated PFS representative to maintain on going reports for AR with the IPAs

    Work directly with designated PFS representative developing a checklist that creates efficiencies in tracking all aspects of transplant billing/collection as well as specific, individual contract terms that may be required by individual Payors.

  • Information Development: Serve as the collection point of all information related to OOS Medicaid and non-contracted HMO cases: demographics, reimbursement terms, prompt billing & payment timelines, problems per case/state; prepare report with summary information as needed by Leadership
  • Review inpatient report daily to identify unplanned OOS Medicaid patients & education needed by Divisions/teams re: OON process for follow up

    Help identify areas in need of assistance to ensure that OOS Medicaid and non-contracted HMO cases are identified appropriately

  • Identify and investigate OOS Medicaid and non-contracted HMO cases:
  • Establish/manage positive partnering relations with all internal and external partners.
  • Coordinate with PFS/Transplant billers to assist in evaluation of performance (profit/loss) of transplant contracts aggregated at program level
  • Develop Actual vs Expected reporting to monitor Transplant contract performance
  • Participate with PFS to identify any potential errors/contract compliance in transplant billing per contract/LOA
  • In conjunction with Managed Care Operations, perform analysis to establish targeted reimbursement levels in all agreements.
  • Participate/engage in Commercial/Medicaid payor meetings
  • Participate in internal meetings as appropriate including but not limited to Medical Management meetings, denial meetings, etc.
  • Become and remain on an ongoing basis, knowledgeable on the "No Surprise Billing Act" including revisions and amendments
  • Assist in investigating Financial Council cases for annual report
  • Assist in tracking Financial Council cases for concurrent monitoring against Financial Council budget in real time
  • Reasonably assist Case Management team with appeals based on contract terms.
  • Other responsibilities as assigned.

Additional Responsibilities

Position entails leading, assigning work to others, and frequent follow-up.

Knowledge, Skills and Abilities:

  • A Bachelor's degree is required. Masters Degree preferred.
  • Nursing Background is a plus.
  • Knowledge of EPIC is a plus.
  • 5 years of healthcare experience in managed care negotiations (Payor or provider) preferred.
  • Transplant experience and familiarity required.
  • Strong analytical ability is required
  • High level of communication skills

Education

Bachelor's Degree (Required)

Pay Range

$99,840.00-$164,736.00 Salary

At Lurie Children's, we are committed to competitive and fair compensation aligned with market rates and internal equity, reflecting individual contributions, experience, and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions.In addition to base salary, Lurie Children's offer a comprehensive rewards package that may include differentials for some hourly employees, leadership incentivesfor select roles, health and retirement benefits, and wellbeing programs. For more details on other compensation, consult your recruiter or click the followinglink to learn more about our benefits.

Benefit Statement


For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:

Medical, dental and vision insurance

Employer paid group term life and disability

Employer contribution toward Health Savings Account

Flexible Spending Accounts

Paid Time Off (PTO), Paid Holidays and Paid Parental Leave

403(b) with a 5% employer match


Various voluntary benefits:

  • Supplemental Life, AD&D and Disability
  • Critical Illness, Accident and Hospital Indemnity coverage
  • Tuition assistance
  • Student loan servicing and support
  • Adoption benefits
  • Backup Childcare and Eldercare
  • Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members
  • Discount on services at Lurie Children's facilities
  • Discount purchasing program

There's a Place for You with Us


At Ann & Robert H. Lurie Children's Hospital of Chicago and its affiliates (collectively "Lurie Children's"), we embrace and celebrate diversity and equity in a serious way. We are committed to building a team with a variety of backgrounds, skills, and viewpoints - recognizing that diverse identities strengthen our workplace and the care we can provide to the Chicago community and beyond. We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging and allyship.This is a place where you can be your best, so we can give our best to the patients and families who trust us with their care.


Lurie Children's and its affiliates are equal employment opportunity employers. We value diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law.


For questions about how to request an accommodation please contact: employeehealth@luriechildrens.org


AI Notice


Lurie Children's utilizes certain AI-enabled features within our recruiting platform to support candidate engagement and assist recruiters in identifying and prioritizing applicants whose experience aligns with job requirements. All employment decisions are made by individuals.


It is a civil rights violation with respect to recruitment, hiring, promotion, or employment for an employer to use artificial intelligence that has the effect of subjecting employees to discrimination on the basis of protected classes under the Illinois Human Rights Act or to use zip codes as a proxy for protected classes.


For questions about the use of artificial intelligence in this process or any additional support, please contact: peoplequestions@luriechildrens.org

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