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Managed Care Jobs (NOW HIRING)

Washington Hospital

Director, Managed Care

Fremont, CA

$196K - $294K/yr

Director, Managed Care Contracting Position Summary The Director, Managed Care Contracting, contributes to WHHS' growth and profitability by providing contracting expertise to existing and new ...

HSS

Managed Care Manager

New York, NY · On-site

$112K - $170K/yr

What you will be doing Managed Care Manager Reporting to the Director of Payer Relations, the Managed Care Manager will play a critical support role in facilitating engagement between Insurance ...

Washington Hospital

Director, Managed Care

Fremont, CA · On-site

$196K - $294K/yr

Director, Managed Care Contracting Position Summary The Director, Managed Care Contracting, contributes to WHHS' growth and profitability by providing contracting expertise to existing and new ...

Ensign Services

Managed Care Resource

Charlotte, NC

Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Charlotte, NC area. About the ...

Pennant Services

Managed Care Contracting Manager

The Managed Care Resource will negotiate managed care payer contract rates and terms and provide guidance with regards to the development of managed care relationships, ensuring timeliness and ...

Cardinal Health

Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting, enrollment, credentialing, and any other ...

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Managed Care information

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How much do managed care jobs pay per year?

As of Aug 27, 2026, the average yearly pay for managed care in the United States is $88,749.00, according to ZipRecruiter salary data. Most workers in this role earn between $72,500.00 and $103,500.00 per year, depending on experience, location, and employer.

What is managed care?

Managed care refers to a healthcare delivery system designed to manage cost, utilization, and quality. It involves a network of providers and organizations that coordinate patient care to improve health outcomes while controlling expenses. Managed care plans often require members to choose healthcare providers from a specific network and may require pre-authorization for certain services. Common types of managed care include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Point of Service (POS) plans.

What are the most common challenges faced by professionals working in managed care roles?

Professionals in Managed Care often navigate complex regulatory requirements while balancing cost efficiency and quality patient care. One common challenge is coordinating between healthcare providers, insurance companies, and patients to ensure effective coverage and access to services. Additionally, staying updated on frequently changing policies and negotiating contracts can require strong analytical and communication skills. Collaboration with interdisciplinary teams is essential, and adaptability is key to managing evolving healthcare trends and payer guidelines.

What are the key skills and qualifications needed to thrive in managed care, and why are they important?

To excel in Managed Care, you need strong analytical abilities, knowledge of healthcare regulations, and typically a degree in healthcare administration, public health, or a related field. Familiarity with claims processing systems, data analytics tools, and industry-specific software such as Epic or Meditech is often required. Excellent communication, negotiation, and problem-solving skills help professionals build relationships with providers and navigate complex patient needs. These competencies are crucial for optimizing patient outcomes, controlling costs, and ensuring compliance within the evolving healthcare landscape.

What is the difference between Managed Care vs Health Insurance Coordinator?

AspectManaged CareHealth Insurance Coordinator
CredentialsTypically requires a degree in healthcare administration, nursing, or related fieldsOften requires knowledge of insurance policies, customer service, and sometimes certifications like CPC or HIPAA training
Work EnvironmentHospitals, insurance companies, healthcare networksInsurance companies, healthcare offices, clinics
Employer & Industry UsageHealthcare providers, insurance plans, government programsInsurance providers, healthcare organizations
Common Search & Comparison IntentUnderstanding managed care plans, healthcare managementManaging insurance claims, policy details

Managed Care professionals focus on coordinating healthcare services within managed care plans, emphasizing cost control and quality. Health Insurance Coordinators handle insurance policies, claims, and customer support. While both roles involve insurance, managed care is broader, often involving healthcare management, whereas insurance coordinators focus on policy administration.

What are examples of managed care?

Managed care involves health care organizations coordinating services to improve quality and control costs, often through health maintenance organizations (HMOs), preferred provider organizations (PPOs), and point-of-service (POS) plans. These models emphasize preventive care, network restrictions, and utilization management, requiring managed care professionals to oversee provider networks and patient care plans.
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Managed Care jobs near you
Infographic showing various Managed Care job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 71% Full Time, 20% Part Time, and 7% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $88,749 per year, or $42.7 per hour.

Director, Managed Care

Fremont, CA

Washington Hospital
Hospitals • 1 - 5K employees
Learn more about Washington Hospitalexternal

$196K - $294K/yr

Full-time

Re-posted 18 days ago

Job description

 Salary Range: $196,000.00 - $294,000.00


Washington Hospital Healthcare System Job Description  

Job Code: 714  

The Director, Managed Care Contracting, contributes to WHHS’ growth  

Job Title: Director, Managed Care Contracting  

Position Summary  
The Director, Managed Care Contracting, contributes to WHHS’ growth and profitability by providing contracting expertise to existing and new contractual relationships; and providing subject matter expertise, guidance, and direction regarding Managed Care Contracts.  This includes coordination of commercial, Medicare Advantage, Medi-Cal Managed Care, Value-Based, Medicare Shared Savings, and other third party managed care contracts and Payor relation activities for Washington Hospital, Washington Township Medical Foundation, and DEVCO entities (surgery centers and other ancillary entities).  The Director will be responsible for overseeing administration, review, and financial analyses of managed care contracts for the healthcare system, performing financial reporting and financial modeling for senior management strategic managed care decision­ making, and overseeing all Payor relations and managed care denial follow-up and resolution activities for the health care system.  In addition to performing the essential functions listed below, may also be assigned other duties as required.
 
Statement of Accountability:

Reports to: Vice President & Chief Revenue Officer  

Qualifications 

  • Education:

Required:  Bachelor's degree (minimum ten 10 years’ experience can be substituted for formal education). 

Desirable:  Master's degree in health related field 

  • Experience: 

-    Minimum seven (7) years in a Managed Care Contracting capacity within a health plan or hospital; and at least the five (5) years of experience managing and mentoring Contract Manager or Payor Relations representatives.

-    Experience in an administratively responsible position with significant intra-department work. 

-    Demonstrated interpersonal skills. 

-    Demonstrated skill in working with a large variety of people of various organizations and levels. 

-    Knowledge of legal terminology, understanding of governmental and legislative regulations. 

-    Previous experience in the areas of managed care/finance/or patient accounting. 

-    Demonstrated ability to perform financial analysis, including managed care contracting financial modeling. 

-    Computer Skills:  Financial Modeling, Windows 2000, Excel, 2000, Work 2000, PowerPoint. 

  • Skills and Abilities: 
-         Must possess technical and professional skills and knowledge of finance, patient accounting functions and managed care.  Must possess strong interpersonal skills, be an effective public speaker and be comfortable in working with diverse groups of individuals.  Must be able to competently represent Washington Hospital at administrative functions.   Must be able to work independently and creatively.

Essential Job Responsibilities 

  • Responsible for negotiating Managed Care Contracts.  This includes routine contracting activities, maintaining strategic relationships, evaluating contracts, and acting as an internal resource in interpreting contracts.
  • Responsible for the initial reading and financial analysis of managed care contracts for content, administrative issues, and appropriate financial return. 
  • Evaluate financial performance of existing contractual relationships and monitor performance of new contractual relationships.  This includes production of financial impact reports on an ongoing basis by both Payor and medical group.
  • Working closely with Managed Care and Finance leadership to develop contract proposals based on WHHS’ defined strategies, goals and objectives.
  • Working closely with WHHS Strategy to participate in Employer Direct contracting, contracting for new WHHS services, and other strategic growth initiatives that require managed care contracting support.
  • Prepare historical and financial data to provide support for contract negotiations and contract renewals. 

5.   Ensuring appropriate dissemination of contract details to all applicable stakeholders. 

  • Always ensures the accuracy and completeness of all projects, information, and analysis. 
  • Support WHHS RCM and Compliance with price transparency efforts and initiatives. 
Demonstrates Skill

1. Direct and oversee Contract Manager to perform modeling, financial impacts, utilizing Financial Planning and Analysis data based on a project-by-project basis. 

2. Develop recommendations regarding rates and contract language for new and renewed contracts. 

3. Administer managed care contracts, as well as develop and monitor tracking and reporting mechanisms to ensure appropriate reimbursement and adherence to contract terms. 

4.   Work with all relevant Washington Hospital Healthcare System computer systems to garner needed information for financial modeling, tracking, analysis, customer relations, etc. 

5. Work with internal departments, particularly Utilization Management and Patient Financial Services, to proactively promote managed care and to ensure appropriate working relationship between Washington Hospital Healthcare Systems and Payor/medical groups. 

6. Stand in for Chief Revenue Officer when needed at intra-hospital and external hospital meetings. 

7.  Always complies with established department policies and guidelines in developing projects, information and analysis. 

8. Consistently challenges the appropriateness of assumptions and formulas used in the preparation of all projects, information and analysis.

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