Director, Managed Care Analytics

Beacon Hill; San Antonio (TX); On-site; USD 180,000 - 260,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

Paid time off

Job summary

Beacon Hill seeks an accomplished Director of Managed Care Analytics to lead enterprise payer analytics, contract modeling, and performance optimization. You will develop advanced financial and predictive models to support value-based care and revenue growth.

The role drives AI-enabled decision support, automates processes, and delivers real-time insights across the payer lifecycle, partnering with Finance, IT, and clinical operations.

Qualifications

• Education: Bachelor's in Finance, Healthcare Administration, Data Analytics, Statistics or related field.
• Preferred MBA/MHA or Health Informatics/Data Science; graduate-level preparation preferred.
• 8+ years in healthcare analytics, decision support, or revenue cycle analytics; leadership exp.

Responsibilities

• Lead enterprise payer analytics, contract modeling, and performance optimization.
• Develop AI-enabled workflows for contract performance monitoring and denial prevention.
• Advise executive leadership on payer strategy and value-based care initiatives.
• Partner across Patient Services, Revenue Integrity, Finance, and IT for data governance and insights.

Skills

Advanced Excel

Data modeling

Tableau

AI in analytics

Predictive modeling

Executive communication

Leadership

Education

Bachelor's degree in Finance or Healthcare Administration

Master's degree in MBA/MHA/Health Informatics/Data Science

Tools

Epic Resolute

Contract modeling tools

Job description

The Director, Managed Care Analytics serves as an enterprise leader within a health care system for payer analytics, contract modeling, and contract performance optimization. This role is responsible for developing advanced financial, statistical, and predictive models to support managed care contracting strategy, value-based care performance, and revenue optimization.

The Director transforms traditional analytics into a modern, AI-enabled decision support function by leveraging automation, machine learning, and advanced data platforms to deliver predictive, prescriptive, and real-time insights across the payer lifecycle.

This position partners closely with Patient Business Services, Revenue Integrity, Patient Access, Finance, Clinical Operations, and Information Technology to ensure data integrity, actionable insights, and alignment with organizational priorities. The Director serves as a strategic advisor to executive leadership on payer strategy, contract performance, reimbursement optimization, and value-based care initiatives.

Additionally, the Director helps guide AI governance and the responsible use of data and analytics across the health care system, ensuring transparency, regulatory compliance, ethical use of artificial intelligence, and appropriate human oversight in decision-support processes.

What Success Looks Like

Within the first 12 to 24 months, the Director will:

• Establish a scalable, enterprise-wide payer analytics framework that integrates claims, clinical, and contract data into a unified decision-support capability.
• Deliver measurably enhanced visibility into payer performance across all major lines of business, enabling proactive contract management and revenue optimization.
• Deploy initial AI-enabled workflows supporting contract performance monitoring, underpayment detection, and denial prevention.
• Strengthen strategic alignment between payer relations, revenue cycle operations, and clinical leadership through shared data and analytics infrastructure.
• Elevate analytics as a recognized strategic driver of payer performance, financial outcomes, and organizational growth.

Education/Experience

Education

Required: Bachelor's Degree in Finance, Healthcare Administration, Data Analytics, Statistics, or a related field.

Preferred: Master's degree (MBA, MHA, Health Informatics, Data Science, or equivalent). Graduate-level preparation is strongly preferred for this enterprise analytics leadership role.

Experience

8 or more years of progressive experience in healthcare analytics, decision support, or revenue cycle analytics.

3 to 5 or more years in a leadership or management role.

Demonstrated experience leading payer contract modeling and supporting negotiation strategy.

Experience with value-based care and alternative payment models.

Experience building or modernizing analytics capabilities preferred.

Technical and Functional Expertise

• Advanced proficiency in Excel and data modeling.
• Advanced proficiency in BI tools such as Tableau.
• Experience with healthcare data including claims, clinical records, and EHR data.
• Experience with contract modeling tools and systems.
• Working knowledge of AI applications in healthcare analytics.
• Working knowledge of predictive modeling.

Domain Knowledge

• Strong working knowledge of Medicare Advantage, Medicaid (including Texas programs), and commercial exchange products.
• Strong knowledge of reimbursement methodologies and contract structures.
• Familiarity with data integration challenges in healthcare.

Licensure

• HFMA certification preferred.
• Epic Resolute expected reimbursement certification required.

Desired Skills and Experience

• 8+ years of healthcare analytics
• Payer contract modeling
• Leadership experience
• Epic Resolute certification (reimbursement modeling, calculation)

Key Competencies

• Epic contract modeling
• Strategic translation
• Systems thinking
• Executive communication
• Builder mindset

Beacon Hill is an equal opportunity employer and individuals with disabilities and/or protected veterans are encouraged to apply.

California residents

Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

Benefits Information

Beacon Hill offers a robust benefit package including, but not limited to, medical, dental, vision, and federal and state leave programs as required by applicable agency regulations to those that meet eligibility. Upon successfully being hired, details will be provided related to our benefit offerings.

We look forward to working with you.

Beacon Hill. Employing the Future™