Director of Managed Care Negotiations & Strategy

Augusta-Health; Fishersville (VA); On-site; USD 180,000 - 240,000; Full time

Benefits offered by this job

Comprehensive insurance package

Retirement savings plans

Earned Wage Access Program

Paid time off

Career development programs

Tuition reimbursement

Onsite childcare

Free onsite parking

Health Fitness Reimbursement Program

Onsite credit union

Pharmacy on site

Job summary

Augusta Health in Fishersville, Virginia seeks a Director of Managed Care Contracting to drive enterprise strategy, negotiate terms with major payers, and oversee direct contracting for its self-insured employee health plan.

Reporting to the CFO, this role leads financial modeling, regulatory compliance, and cross-functional collaboration to protect net revenue and advance value-based initiatives across hospital, ancillary, and employed physician services.

Qualifications

• Seven years of progressive managed care contracting experience.
• Three years of supervisory or management experience.
• Proven track record negotiating rates, terms with major commercial and Medicare Advantage payers.
• Experience developing and defending financial models and reimbursement analyses.
• Knowledge of self-insured employer health plans and TPAs.

Responsibilities

• Develop and execute Augusta Health’s enterprise managed care contracting strategy.
• Lead negotiations with major payers.
• Monitor market trends, payer product development, and regulatory changes.
• Oversee direct contracting for Augusta Health’s self-insured employee health plan.
• Coordinate with external consultants and advisors to align with organizational goals.
• Monitor contract performance and report on KPIs to leadership.

Skills

Managed care contracting

Payer relations

Financial modeling

Negotiation

Healthcare finance

Regulatory compliance

Leadership

Team management

Education

Bachelor's in Healthcare Administration

MBA or equivalent

Tools

Excel

Contracts management software

Job description

Augusta Health in Fishersville, Virginia seeks a Director of Managed Care Contracting to drive enterprise strategy, negotiate terms with major payers, and oversee direct contracting for its self-insured employee health plan.

Reporting to the CFO, this role leads financial modeling, regulatory compliance, and cross-functional collaboration to protect net revenue and advance value-based initiatives across hospital, ancillary, and employed physician services.