Area VP, Managed Health Payor Contracting

Advocate Health; Milwaukee (WI); Presencial; USD 110 000 - 170 000; Tempo integral

Resumo da oferta

Advocate Health in Milwaukee seeks an experienced leader to direct payer contracting strategies across markets and networks, aligning engagements with enterprise priorities and financial goals. You will negotiate complex fee-for-service and value-based contracts, lead bundled arrangements, and partner with revenue cycle, operations, and contract administration to ensure contract integrity and performance.

The ideal candidate has 8+ years in payer contracting, a Bachelor's degree (MBA/MHA

Qualificações

• Bachelor's degree in Business, Healthcare Administration, Finance, Economics, or related field required.
• Master's degree (MBA, MHA, or equivalent) preferred.
• Minimum 8 years of professional experience with 5+ years in payer contracting or related fields.

Responsabilidades

• Lead development and execution of payer contracting strategies across markets and portfolio scope.
• Serve as primary owner of payer relationships, aligning engagements with enterprise strategy and priorities.
• Lead and oversee negotiation and renegotiation of fee-for-service and value-based contracts across a diverse portfolio.
• Ensure contract terms, rates, and structures meet financial, operational, and compliance expectations.
• Develop and execute negotiation strategies, including financial modeling and positioning.
• Lead bundled payment arrangements and contracting with independent providers participating in bundled services.
• Partner with internal divisions including revenue cycle, operations, and contract administration teams.
• Monitor and manage portfolio performance, including financial modeling, risk assessment, and recommendations.
• Translate market trends, payer dynamics, and regulatory changes into actionable contracting strategies.
• Lead and develop high-performing teams while influencing cross-functional stakeholders across the organization.

Conhecimentos

Payer contracting

Negotiation

Financial modeling

Relationship management

Executive communication

Strategic thinking

Formação académica

Bachelor's degree in Business, Healthcare Administration, Finance, Economics, or related field

Master's degree (MBA, MHA, or equivalent) preferred

Descrição da oferta de emprego

Major Responsibilities:

• Lead development and execution of payer contracting strategies across assigned markets, payers, and portfolio scope, including recommendations on payer participation, network positioning, and contract optimization opportunities.


• Serve as primary owner of payer relationships, aligning engagements with enterprise strategy and priorities.


• Lead and oversee negotiation and renegotiation of fee-for-service and value-based contracts, including complex risk-based arrangements, across a diverse portfolio of 20+ provider types spanning acute, post-acute, and clinically integrated networks.


• Ensure contract terms, rates, and structures meet financial, operational, and compliance expectations.


• Develop and execute negotiation strategies, including financial modeling and positioning.


• Lead bundled payment arrangements and contracting with independent providers participating in bundled services (e.g., transplant and other specialty programs), ensuring alignment with financial, operational, and legal requirements.


• Partner with internal divisions/areas including but not limited to revenue cycle, operations, and contract administration teams to ensure accurate implementation and ongoing integrity of contracts.


• Monitor and manage portfolio performance, including financial modeling, risk assessment, and development of recommendations to support decision-making across revenue, margin, reimbursement, and payer mix.


• Translate market trends, payer dynamics, and regulatory changes into actionable contracting strategies.


• Lead and develop high-performing teams while influencing cross-functional stakeholders across the organization.


• Perform other duties as assigned.

Education Required:

• Bachelor’s Degree in Business, Healthcare Administration, Finance, Economics, or related field required.

• Master’s Degree (MBA, MHA, or equivalent) preferred.

Work Experience Required:

• Minimum of 8 years of professional experience, with at least 5 years in payer contracting, managed care, healthcare financial strategy, or related fields, with demonstrated progressive responsibility.


• Demonstrated success leading complex contract negotiations and achieving financial performance targets.


• Experience across commercial, Medicare Advantage, Medicaid, and value-based payment models preferred.


• Experience in large, integrated health systems or multi-entity provider organizations preferred.

Knowledge, Skills & Abilities Required:

• Strong expertise in payer contracting, reimbursement methodologies, and value-based care models.


• Advanced financial and analytical capabilities, including contract modeling and performance evaluation.


• Strong negotiation, influencing, and relationship management skills.


• Ability to synthesize complex information and translate into strategic recommendations.


• Effective communication and executive presence with ability to engage stakeholders at all levels.


• Demonstrated ability to lead teams and operate effectively in complex, matrixed environments.

Physical Requirements and Working Conditions:

• Primarily operates in a standard office environment with periodic travel.


• Requires extended periods of sitting, with occasional standing, walking, and travel.


• Requires effective verbal and written communication with internal and external stakeholders.


• Visual and auditory acuity required, with or without assistive devices.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.