Director of Managed Care Contracting & Payer Strategy

Connecticut Children's; Hartford (CT); Presencial; USD 180 000 - 280 000; Tempo integral

Resumo da oferta

Connecticut Children’s is seeking a Director, Managed Care Contracting to lead the end-to-end contracting function, drive payer strategy, and optimize reimbursement across hospital, outpatient departments, and specialty groups. This high-impact role reports to the Chief Financial Officer and guides a high-performing team toward growth and mission alignment.

The ideal candidate brings 10+ years in managed care contracting, 5+ years in a multi-hospital setting, and 5+ years of leadership, with

Qualificações

• Education: Bachelor's degree in Business Administration, Healthcare Management, Accounting, Finance, or a related discipline.
• Experience: Minimum of 10 years of progressive experience in managed care contracting; minimum of 5 years in a multi-hospital or health system; at least 5 years of management and leadership experience.
• Education: Master's degree in Business Administration, Healthcare Management, Accounting, Finance, or a related discipline.

Responsabilidades

• Directly manage and develop a portfolio of managed care contracts for the hospital, outpatient departments, and specialty group; serve as the primary contracting lead for all facilities.
• Lead managed care contracting strategy, including analysis of contract proposals, development of counter-proposal terms, and negotiation meetings with payers.
• Review all existing payer agreements and recommend alternative contractual language when terms are ambiguous or detrimental.
• Develop and negotiate provider agreements and payment terms for the medical center and affiliate organizations, including payment models for facility contracts.
• Direct contract modeling activities to assess feasibility of different payment methodologies and their financial impact.
• Research and apply global billing payment models and value-based care structures; challenge assumptions to drive contracting success.
• Research and develop pay-for-performance models and Episode of Care methodologies under ACO or other risk models; coordinate with the accountable care organization.
• Monitor market trends and develop strategy recommendations; develop strategic pricing within payer agreements.
• Represent managed care contracting interests in organizational efforts to build integrated networks and value-based arrangements.

Formação académica

Bachelor's degree in Business Administration, Healthcare Management, Accounting, Finance, or a related discipline

Master's degree in Business Administration, Healthcare Management, Accounting, Finance, or a related discipline

Experience in managed care contracting

Ferramentas

Epic contract management

Contract modeling tools (e.g., STRATA)

Descrição da oferta de emprego

Connecticut Children’s is seeking a Director, Managed Care Contracting to lead the end-to-end contracting function, drive payer strategy, and optimize reimbursement across hospital, outpatient departments, and specialty groups. This high-impact role reports to the Chief Financial Officer and guides a high-performing team toward growth and mission alignment.

The ideal candidate brings 10+ years in managed care contracting, 5+ years in a multi-hospital setting, and 5+ years of leadership, with