Director of Managed Care & Value-Based Strategy

Atlantic Health; Morristown (NJ); On-site; USD 180,000 - 260,000; Full time

Job summary

Atlantic Health is seeking a Director of Managed Care to lead strategy, execution, and performance of all managed care activities across FFS and VBC. Reporting to the VP of Insurance Networks, this role oversees contract negotiations, payer relations, medical economics, and reimbursement modeling.

The Director will develop and monitor hospital, physician, ambulatory, and ancillary agreements, optimize reimbursement, and drive value-based programs including shared savings and capitation, aligning

Qualifications

• Bachelor’s degree or equivalent experience preferred.
• Experience leading managed care strategy and negotiations across FFS and value-based programs.

Responsibilities

• Provide oversight for all managed care contracting across hospitals, physician enterprise, ambulatory centers, ancillaries, and value-based arrangements.
• Develop and execute contracting strategies that anticipate market shifts and payer policy changes.
• Lead the creation of innovative contract structures supporting system-wide financial, operational, and quality goals.
• Build and maintain payer relationships with transparency and accountability.
• Oversee reimbursement planning, pricing of claims, and interpretation of payer policies from internal stakeholders.
• Direct analytics for FFS and VBC performance, including monitoring and optimization of contract metrics.

Skills

Strategic leadership

Contract negotiations

Payer relations

Medical economics

Reimbursement modeling

Value-based programs

Team leadership

Financial forecasting

Tools

Epic

Job description

Atlantic Health is seeking a Director of Managed Care to lead strategy, execution, and performance of all managed care activities across FFS and VBC. Reporting to the VP of Insurance Networks, this role oversees contract negotiations, payer relations, medical economics, and reimbursement modeling.

The Director will develop and monitor hospital, physician, ambulatory, and ancillary agreements, optimize reimbursement, and drive value-based programs including shared savings and capitation, aligning