Managed Care Contract Manager

The Managed Care Contract Manager manages payor contracts throughout their lifecycle, supporting contract negotiations, financial analysis, reimbursement optimization, and revenue integrity. As a member of the Payor Relations team and working closely with the Revenue Cyle team, this role uses data-driven insights to improve contract performance, support strategic negotiations, and maintain strong relationships with payor partners while ensuring alignment with the organization's managed care strategy.

EDUCATION:

- Master’s degree in Business or Healthcare Administration preferred. Bachelor’s degree in Healthcare Administration, Finance, Business Analytics, or a closely related professional discipline, or Associate’s degree and 5 or more years of equivalent verified experience in negotiation, contract management, or payor relations required.

YEARS OF EXPERIENCE:

- 3–5 years of direct experience within a healthcare system, major provider group, or commercial payor environment and experience in negotiating reimbursement and other agreements between healthcare organizations required. Analytics within a healthcare payor and provider relationship setting preferred.

REQUIRED SKILLS AND KNOWLEDGE:

- Financial & Analytical Acumen: Proficiency in financial modeling, data analysis, and contract yield projections required. Advanced Excel capability is required, with experience digesting price transparency files among providers and payors – experience w/ JSON file format preferred.
- Reimbursement Methodologies: Solid, practical understanding of healthcare reimbursement models including MS/APR-DRGs, APCs, fee schedules, value-based care programs, and other payment models.
- Communication & Synergy: Demonstrated ability to translate highly technical or complex financial data into concise, actionable insights for leadership, while maintaining strong relationships with payor representatives.