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On Call Managed Care Contracting Jobs (NOW HIRING)

Main Line Health

Manager, Managed Care Contracting

Radnor, PA · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Minimum of five (5) years of experience in payer contracting, provider contracting, managed care, medical economics, healthcare informatics, or related healthcare strategy functions. * Experience ...

Washington Hospital

Director, Managed Care

Fremont, CA

$196K - $294K/yr

Director, Managed Care Contracting Position Summary and profitability by providing contracting expertise to existing and new contractual relationships; and providing subject matter expertise ...

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 ...

Vrtx

Managed Care Contracting Associate Director

Boston, MA · Hybrid

$152K - $228K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

The Managed Care Contracting Associate Director will provide leadership and management oversight of Market Access Contract processes by facilitating pre- and post-deal analytics, negotiation, and ...

Ensign Services

Managed Care Resource

Pomona, CA · On-site

$110K - $130K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...

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Director, Managed Care

Washington Hospital Healthcare System

Fremont, CA • On-site

$120 - $160/hr

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This job post has expired today. Applications are no longer accepted.

Job description

Washington Hospital Healthcare System

Job Title: Director, Managed Care Contracting

Job Code: 714

Reports To: Vice President & Chief Revenue Officer

Position Summary: The Director, Managed Care Contracting contributes to WHHS growth and profitability by providing contracting expertise and guidance on managed care contracts. This role coordinates commercial, Medicare Advantage, Medi‑Cal, Value‑Based, Medicare Shared Savings and other third‑party managed care contracts and payor relations for Washington Hospital, Washington Township Medical Foundation and DEVCO entities (surgery centers and ancillary entities). The Director oversees administration, review, financial analysis of managed care contracts, financial modeling and reporting for senior management, and manages payor relations, denial follow‑up and resolution activities.

Job Responsibilities
  1. Negotiate managed care contracts, maintain strategic relationships, evaluate contracts, and serve as internal resource for contract interpretation.
  2. Conduct initial reading and financial analysis of managed care contracts for content, administrative issues and expected financial return.
  3. Evaluate financial performance of existing contracts and monitor the performance of new contracts, producing regular financial impact reports.
  4. Collaborate with Managed Care and Finance leadership to develop contract proposals aligned with WHHS strategies, goals, and objectives.
  5. Work with WHHS Strategy to support employer direct contracting, new service contracting, and strategic growth initiatives requiring managed care contracting support.
  6. Prepare historical and financial data to support contract negotiations and renewals.
  7. Disseminate contract details to all stakeholders, ensuring accurate and complete project information and analysis.
  8. Support WHHS RCM and compliance with price transparency initiatives.
  9. Maintain accuracy and completeness of all projects, information, and analyses.
  10. Assist senior management with decision‑making regarding managed care and strategic issues.
Qualifications
  • Education: Bachelor’s degree required (minimum 10 years of related experience); Master’s degree in health‑related field preferred.
  • Experience: Minimum 7 years in managed care contracting or a related capacity within a health plan or hospital, including at least 5 years of experience managing and mentoring contract or payor‑relations representatives.
  • Experience in an administratively responsible position with significant intra‑department work.
  • Demonstrated interpersonal skills and ability to work with diverse groups at various organizational levels.
  • Knowledge of legal terminology, governmental regulations, and legislative requirements.
  • Background in managed care, finance, or patient accounting.
  • Ability to perform financial analysis and managed care contracting financial modeling.
  • Computer skills in financial modeling, Microsoft Office (Excel, PowerPoint), and system reports.
  • Strong interpersonal skills, effective public speaking, and independent, creative work style.
  • Proven ability to represent the organization in administrative functions.
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