Managed Care Contracts Strategist & Performance Lead

Guidehouse; Washington (District of Columbia); Hybrid; USD 113,000 - 188,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401(k) Plan

Tuition Reimbursement

Job summary

Guidehouse seeks a seasoned Managed Care Contracting and Performance Advisor to lead contract evaluation, modeling, and payer negotiations. You will partner with Finance, Revenue Cycle, and physician services to optimize reimbursement and mitigate risk across hospital and physician lines.

You will interpret complex contract language, develop business cases, and monitor performance against KPIs, driving revenue improvement and stronger payer relationships.

Qualifications

• Bachelor's degree required; 6–8+ years of relevant healthcare contracting experience preferred.
• Experience negotiating managed care agreements with commercial and government plans desired.
• Strong analytical, financial modeling, and contract interpretation skills essential.

Responsibilities

• Evaluate existing managed care contracts to identify reimbursement improvement opportunities and risk.
• Develop strategic negotiation plans and counterproposals with data support.
• Coordinate implementation of new/ amended agreements across Finance, Revenue Cycle, and Operations.
• Monitor contract performance, address underpayments/denials, and prepare executive summaries.

Skills

Negotiation

Financial modeling

Contract language

Analytical skills

Communication

Relationship management

Education

Bachelor's degree

Tools

Excel

PowerPoint

Healthcare analytics tools

Job description

Guidehouse seeks a seasoned Managed Care Contracting and Performance Advisor to lead contract evaluation, modeling, and payer negotiations. You will partner with Finance, Revenue Cycle, and physician services to optimize reimbursement and mitigate risk across hospital and physician lines.

You will interpret complex contract language, develop business cases, and monitor performance against KPIs, driving revenue improvement and stronger payer relationships.