Manager, Managed Care Contracting

Main Line Health; Radnor (Delaware County); On-site; USD 101,857 - 157,809; Full time

Benefits offered by this job

PTO 6 weeks

Medical, dental, vision

Employer-funded pension + 403(b) match

Tuition reimbursement

Professional development

Employee discounts

Free employee parking

Job summary

Main Line Health in Radnor, PA is seeking a Manager of Payor Strategies to lead payer negotiations and manage relationships with insurance providers. This hybrid role collaborates with Finance, Patient Access, and Compliance to optimize reimbursement and ensure strategic payer contracts across acute care, rehab, and ancillary services.

The role requires 5+ years in payer contracting or related healthcare strategy, strong negotiation skills, and advanced Excel.

Qualifications

• Bachelor’s degree or higher in a related field.
• 5+ years in payer contracting or comparable healthcare strategy role.
• Experience in hospital/health system payer environment.
• Strong contract negotiation and relationship management.

Responsibilities

• Lead negotiations and management of payer agreements across MLH entities.
• Serve as primary relationship manager for assigned insurers.
• Analyze reimbursement methodologies and contract performance for optimization.
• Develop payer-provider arrangements including value-based models.
• Monitor contract performance and collaborate with finance and operations.

Skills

Payer contracting

Contract negotiation

Financial analysis

Stakeholder management

Healthcare economics

Excel proficiency

Education

Bachelor's degree in Healthcare Administration/Business/Finance

Minimum 5 years payer contracting or related healthcare strategy

Tools

Microsoft Excel

Microsoft Office

Job description

Manager, Payor Strategies

Location: Radnor, PA (Hybrid)

Schedule: Full-Time Day Schedule

Compensation: $101,857.60 - $157,809.60

Why This Role Matters

Healthcare is rapidly evolving, and strong payer partnerships are critical to ensuring patients have access to quality care while maintaining the financial strength needed to invest in our communities. As the Manager, Payor Strategies, you will play a key role in shaping Main Line Health's relationships with insurance providers, negotiating contracts that support our mission, optimize reimbursement, and position the organization for success in an increasingly complex healthcare landscape.

Working at the intersection of strategy, finance, revenue cycle, and operations, you'll influence decisions that impact millions of dollars in reimbursement, support innovative value-based care initiatives, and help ensure Main Line Health can continue delivering exceptional care to the patients and communities we serve.

Benefits & Perks

• Up to 240 hours (6 weeks) of paid time off annually
• Comprehensive medical, dental, and vision coverage
• 100% Employer-Funded Pension Plan + 403(b) Match
• Tuition reimbursement of up to $6,000 annually
• Professional development, training, and certification support
• Employee discounts on services and activities
• Free employee parking

What You'll Do

As the Manager, Payor Strategies, you'll serve as a strategic leader responsible for managing a select group of payer relationships and ensuring Main Line Health is well-positioned in an evolving healthcare landscape. You'll combine contract negotiation expertise, financial analysis, and cross-functional collaboration to drive organizational success. In this role, you will be accountable for negotiating, developing, and monitoring payor contracts across the enterprise to maximize Main Line Health's strategic goals. This position provides support to Patient Access, Patient Accounting, and Finance Directors to ensure the proper implementation and monitoring of payor contracts and compensation terms for all MLH entities (Acute Care, Acute Rehabilitation, Employed Physician and Ancillary Services).

Key Responsibilities

• Lead negotiations, implementation, and ongoing management of payer agreements across Main Line Health's acute care, physician, rehabilitation, and ancillary service lines.
• Serve as the primary relationship manager for assigned insurance providers, fostering strong partnerships and resolving operational and contractual challenges.
• Analyze reimbursement methodologies, fee schedules, contract performance, and compensation structures to identify opportunities for optimization.
• Support the development of innovative payer-provider arrangements, including value-based payment models and alternative reimbursement strategies.
• Monitor contract performance and collaborate with operational leaders to improve outcomes related to revenue cycle operations, patient access, utilization management, and reimbursement.
• Provide expertise and guidance regarding payer contract language, compensation terms, and reimbursement methodologies.
• Facilitate meetings with payer representatives and internal stakeholders to strengthen performance, address challenges, and improve partnership outcomes.
• Stay informed on regulatory, legislative, and market changes impacting managed care, accountable care organizations (ACOs), clinically integrated networks (CINs), and healthcare reimbursement.

Team Collaboration & Growth

Success in this role requires strong partnership across the organization. You'll work closely with leaders throughout Finance, Revenue Cycle, Patient Access, Patient Accounting, Compliance, Legal, Care Management, and operational teams to ensure contracts are effectively implemented and optimized.

This role offers the opportunity to:

• Influence strategic decisions that impact the financial health of a leading healthcare system.
• Build executive-level relationships with major payer organizations throughout the region.
• Drive innovative reimbursement and value-based care initiatives.
• Expand expertise in healthcare economics, managed care strategy, contract negotiation, and payer relations.
• Gain broad exposure across clinical, operational, financial, and regulatory functions within a complex health system.

What You Bring

Required Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, Economics, Public Health, or a related field.
• Minimum of five (5) years of experience in payer contracting, provider contracting, managed care, medical economics, healthcare informatics, or related healthcare strategy functions.
• Experience working within a health system, hospital, healthcare organization, managed care organization, or insurance payer environment.
• Strong contract negotiation and relationship management skills.
• Demonstrated analytical, financial modeling, and problem-solving abilities.
• Advanced Microsoft Excel proficiency and strong working knowledge of Microsoft Office applications.
• Exceptional communication, presentation, and stakeholder management skills.
• Ability to independently manage multiple priorities in a fast-paced environment while maintaining strong attention to detail.

Preferred Qualifications

• Master's degree in Business Administration (MBA), Healthcare Administration (MHA), Finance, or a related field.
• Experience with value-based reimbursement models, population health strategies, or alternative payment arrangements.
• Knowledge of Accountable Care Organizations (ACOs), Clinically Integrated Networks (CINs), and evolving healthcare reimbursement models.
• Experience conducting reimbursement analyses, fee schedule reviews, and contract modeling.
• Prior experience leading complex negotiations involving healthcare payers, providers, or managed care organizations.

Join Our Team Today!

At Main Line Health, you'll find more than a job-you'll find an opportunity to influence the future of healthcare. As our next Manager, Payor Strategies, you'll help shape critical payer partnerships, drive meaningful financial outcomes, and support innovative care delivery models that benefit both our organization and the communities we serve.

If you're a strategic thinker who thrives on relationship building, contract negotiation, and solving complex healthcare challenges, we invite you to bring your expertise to a collaborative, mission-driven team dedicated to making a lasting impact.

Join Main Line Health and help us create stronger partnerships, healthier communities, and a brighter future for healthcare. Apply today!

Employee Status: Regular

Schedule: Full-time

Shift: Day Job

Pay Range: $101,857.60 - $157,809.60

Job Grade: 116