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Managed Care Organization Jobs (NOW HIRING)

VMG Health

Director, Managed Care

Nashville, TN · On-site

Serve as the lead consultant on managed care and payer strategy engagements for hospitals, health systems, physician organizations, ambulatory surgery centers, infusion providers, and other health ...

Ensign Services

Managed Care Resource

Orlando, FL · On-site

Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation ... Communicate effectively at all organizational levels and in situations requiring instructing ...

VMG Health

Director, Managed Care

Nashville, TN · On-site

Serve as the lead consultant on managed care and payer strategy engagements for hospitals, health systems, physician organizations, ambulatory surgery centers, infusion providers, and other health ...

Humana, Inc.

Actuary - Primary Care Organization

The Actuary, Primary Care Organization (PCO) is responsible for supporting actuarial analytics ... This technology provides our team of recruiters and hiring managers with an enhanced method for ...

Ensign Services

Managed Care Resource

Nashville, TN · On-site

Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation ... Communicate effectively at all organizational levels and in situations requiring instructing ...

Ensign Services

Managed Care Resource

Los Angeles, CA · On-site

$110K - $130K/yr

Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 ... Communicate effectively at all organizational levels and in situations requiring instructing ...

Washington Hospital

Director, Managed Care

Fremont, CA

$196K - $294K/yr

... 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 ...

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$60K

$88.7K

$124K

How much do managed care organization jobs pay per year?

As of Jul 26, 2026, the average yearly pay for managed care organization 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 are typical daily responsibilities for someone working within a Managed Care Organization?

In a Managed Care Organization, daily responsibilities often include reviewing and processing insurance claims, coordinating care among healthcare providers, ensuring regulatory compliance, and managing member enrollment or benefits. Employees frequently interact with healthcare providers, members, and internal teams to resolve issues and support optimal care delivery. Data analysis for quality improvement initiatives and process refinement is also common. The role tends to be collaborative, involving cross-functional teamwork to meet organizational goals and improve patient outcomes.

What are the key skills and qualifications needed to thrive in the Managed Care Organization position, and why are they important?

To excel in a Managed Care Organization (MCO) role, professionals typically need expertise in healthcare administration, insurance regulations, and population health management, often supported by degrees in healthcare or business and relevant certifications such as Certified Managed Care Professional (CMCP). Familiarity with claims processing systems, electronic health records (EHR), and utilization management software is essential. Strong analytical thinking, negotiation, and communication skills are crucial for collaboration and problem-solving. These competencies enable effective coordination between providers, payers, and patients to optimize care quality and cost efficiency.

What is a Managed Care Organization job?

A Managed Care Organization (MCO) job involves overseeing and coordinating healthcare services to ensure cost-effective, high-quality care for members. Roles within an MCO vary but often include case management, provider network development, claims processing, and regulatory compliance. Employees work to improve healthcare access, manage costs, and ensure that providers meet quality standards. These jobs can be found in insurance companies, government programs, and healthcare service providers.

More about Managed Care Organization jobs
What cities are hiring for Managed Care Organization jobs? Cities with the most Managed Care Organization job openings:
What states have the most Managed Care Organization jobs? States with the most job openings for Managed Care Organization jobs include:
What job categories do people searching Managed Care Organization jobs look for? The top searched job categories for Managed Care Organization jobs are:
Managed Care Organization jobs near you
Infographic showing various Managed Care Organization job openings in the United States as of July 2026, with employment types broken down into 2% As Needed, 70% Full Time, 21% Part Time, and 7% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $88,749 per year, or $42.7 per hour.
Manager Managed Care Contracting

Manager Managed Care Contracting

BJC HealthCare

Saint Louis, MO • On-site

$83K - $136K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 days ago

BJC Healthcare rating

7.6

Company rating: 7.6 out of 10

Based on 227 frontline employees who took The Breakroom Quiz

188th of 890 rated healthcare providers

Job description

Additional Information About the Role
BJC is seeking a Manager of Managed Care Contracting. This role oversees value-based contracting across the organization, including negotiating with insurance providers and implementing contract agreements. The ideal candidate will have prior experience with value-based contracts and a strong understanding of coding and documentation practices.
Must be located in the greater St. Louis area.
Overview
BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.
BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.
BJC's patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children's Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.
The BJC Managed Care department includes multiple functions such as managed care contracting, financial analysis, systems and operations, value-based care and payment programs, payor and provider relations, and direct to employer solutions.
Preferred Qualifications
Role Purpose
In collaboration with leadership, the Managed Care Contracting Manager manages and leads the contract negotiations with the Managed Care Organizations (MCOs), including rate and language discussions in accordance with established guidelines and aligned with BJC strategic goals. This position develops and maintains strong relationships with the Managed Care Organizations (MCOs). This position also collaborates with the HSOs in order to identify challenges and opportunities for improvement around contract performance.
Responsibilities
  • Manages individual(s) including but not limited to: onboarding and hiring, training, workload management & performance evaluations, conducting professional development plans as needed. Ensures that the productivity and actions of that group meet/support the overall operational goals of the department as established by department leadership.
  • Negotiates complex managed care contracts on behalf of the BJC HSOs including hospitals, physicians, home care, behavioral health and other ancillary providers; leads contract discussions with managed care organizations, including reviewing and drafting contract language provisions that protect BJC's revenue and improve administrative functions and negotiating rates within established guidelines.
  • Facilitates problem solving of identified contractual and operational issues in collaboration with managed care organizations and internal stakeholders; identifies and communicates opportunities for process improvement with managed care organizations and internal stakeholders.
  • Stays abreast of changing healthcare landscape to maintain an awareness of competitor services and reimbursement models, as well as opportunities for improvement in the financial and operational components of managed care contracts; leads discussions pertinent to contract performance, market changes, market intelligence, and strategic decision making.
  • Coordinates with analytical team to ensure contractual terms, including payer-specific requirements, reimbursement logic, and limitations are understood and appropriately included in any modeling systems.

    • Minimum Requirements
    Education
  • Bachelor's Degree

    • Experience
  • 5-10 years

    • Supervisor Experience
  • 2-5 years

    • Preferred Requirements
    Education
  • Master's Degree

    • Experience
  • 10+ years

    • Supervisor Experience
  • 5-10 years

    • Benefits and Legal Statement
    BJC Total Rewards
    At BJC we're committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.
    • Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
    • Disability insurance* paid for by BJC
    • Annual 4% BJC Automatic Retirement Contribution
    • 401(k) plan with BJC match
    • Tuition Assistance available on first day
    • BJC Institute for Learning and Development
    • Health Care and Dependent Care Flexible Spending Accounts
    • Paid Time Off benefit combines vacation, sick days, holidays and personal time
    • Adoption assistance

    To learn more, go to our Benefits Summary
    *Not all benefits apply to all jobs
    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer

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    About BJC Healthcare

    Sourced by ZipRecruiter

    BJC Healthcare, situated in Saint Louis, MO, US, is one of the largest healthcare organizations in the United States. Launched in 1993, BJC encompasses 15 hospitals and multiple health service organizations covering the metropolitan St. Louis area, mid-Missouri and Southern Illinois. This healthcare titan's services cover a vast field, from community health and wellness, to pediatric care, to advanced specialty care. BJC is well-known for its two nationally recognized hospitals, Barnes-Jewish Hospital and St. Louis Children's Hospital, both affiliated with Washington University School of Medicine. Its mission revolves around improving the health and well-being of the communities it serves through leadership, education, innovation, and excellence in medicine.

    Industry

    Health care and social assistance

    Company size

    10,000+ Employees

    Headquarters location

    Saint Louis, MO, US

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