Director, Managed Care Contracting

Socket.dev; Woodbridge Township (NJ); Hybrid; USD 165,000 - 202,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid leave

Tuition reimbursement

Retirement benefits

Job summary

Hackensack Meridian Health is seeking a Director of Managed Care Contracting to lead negotiations and implement contract strategies for hospital, ancillary, physician, and bundle agreements. You will drive language standardization, financial performance, and alignment with contracting parameters.

The role is hybrid with one day per week in the office, requiring strong leadership, communication, and market knowledge to optimize reimbursement and network performance.

Qualifications

• BA or BS in a relevant field is required.
• Five to ten years equivalent healthcare experience.
• Network management and managed care contracting experience.
• Excellent written and verbal communication skills.
• Proficient with Microsoft Office and Google Suite.

Responsibilities

• Direct negotiations of assigned hospital, ancillary, physician and bundle agreements.
• Create and manage adherence to contract language and financial performance standards.
• Lead negotiator in key payer negotiations.
• Develop contracting strategies within the health system parameters.
• Coordinate with teams to plan provider networks and budget objectives.
• Ensure payer relationships and internal alignment at high levels.
• Provide education on contract parameters and changes.

Skills

Communication skills

Network management

Managed care contracting

Education

BA/BS in relevant field

Master's degree (preferred)

Tools

Microsoft Office

Google Suite

Job description

Overview

Our team members are the heart of what makes us better.

At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.

Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

Under the direction of the Vice President, Managed Care, the Director, Managed Care Contracting support the managed care contracting initiatives including but not limited to directing re) negotiating and implementing managed care agreements for the facilities, affiliates, physicians and bundle arrangements within the health system. The incumbent will provide negotiation of contract rates and terms, language implementation and ensure contracts are standardized in accordance with the health systems established contracting parameters.

**This is a Hybrid position - requirement will be one day a week in the office

Responsibilities

A day in the life of a Director, Managed Care Contracting at Hackensack Meridian Health includes:

• Directs the negotiations of assigned hospital, ancillary, physician and bundle agreements.
• Create and manage adherence to contract language and financial performance standards. Act as lead negotiator is certain key payer negotiations. Works within the guidelines outlined in the health system's contracting parameters to develop contracting strategies, evaluate the current performance of managed care and population health contracts, assist in forming the model to evaluate and proposals or counter proposals received or sent to payers; evaluate impact of reimbursement rates and/or methodologies.
• Establish and/or negotiate bundle agreements for specific service lines.
• Provides staff awareness and education on contract parameters and changes.
• Coordinates with Managed Care and Population Health teams to plan and implement strategy for facilities, ancillary and physician providers networks, including action plans for to obtain budget objectives.
• Ensure that relationships with payers and internal matrix partners are maintained at a high level.
• Coordinate the financial reporting and integrity supporting the management and measurement of proposed and implemented health system agreements.
• Leverage historical utilization data and predictive modeling to execute strategies. Engage with Analytics to develop reimbursement benchmarks and identify payment opportunities while streamlining contract performance.
• Team committed solid interpersonal communication skills.
• Other duties and/or projects as assigned.
• Adheres to HMH Organizational competencies and standards of behavior.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• BA or BS required.
• Five to ten years equivalent healthcare experience.
• Network Management, managed care contracting experience.
• Excellent written and verbal communication skills.
• Proficient computer skills that may include but are not limited to Microsoft Office and/or Google Suite platforms.

Education, Knowledge, Skills and Abilities Preferred:

• Master's degree.
• Risk contracting, and risk contract management experience

Starting Minimum Rate

Minimum rate of $183,664.00 Annually

Job Posting Disclosure

HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to: Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness. Experience: Years of relevant work experience. Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training. Skills: Demonstrated proficiency in relevant skills and competencies. Geographic Location: Cost of living and market rates for the specific location. Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization. Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered. Some jobs may also be eligible for performance-based incentives, bonuses, or commissions not reflected in the starting rate. Certain positions may also be eligible for shift differentials for work performed on evening, night, or weekend shifts. In addition to our compensation for full-time and part-time (20+ hours/week) job positions, HMH offers a comprehensive benefits package, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits.