Senior Director, Contract Performance & Compliance

Mount Sinai Health System; New York (NY); On-site; USD 180,000 - 260,000; Full time

Job summary

Mount Sinai Health System seeks a Senior Director, Contract Compliance & Performance to lead the enterprise framework and drive value from payer contracts. You will guide operationalizing contract requirements and analytics across the organization.

You will coordinate with Managed Care, Revenue Cycle, IT, Finance, and clinical leadership, translating contracts into actionable requirements, dashboards, and controls to reduce risk and improve reimbursement.

Qualifications

• Bachelor's degree in healthcare administration, finance, business, accounting, health information management, data analytics, or related field.
• Master's degree preferred (MBA, MHA, MPH, or related).
• 7+ years in healthcare finance, payer contracting, reimbursement, revenue cycle or related field; 10+ years preferred.
• Experience in payer contract performance, reimbursement analytics, payment validation, or revenue-cycle analytics.
• Experience in large academic medical center or integrated health system.
• Experience with facility and professional reimbursement preferred.
• Ability to translate contractual and reimbursement requirements into operational processes and analytics.

Responsibilities

• Execute the enterprise Contract Compliance & Performance framework.
• Monitor payer contract compliance, reimbursement, obligations, and performance.
• Identify, quantify, and prioritize reimbursement variances.
• Translate contractual requirements into documented business, operational, and analytical requirements.
• Partner with Managed Care, Revenue Cycle, IT, Finance, and operational teams on contract implementation.
• Participate in contract configuration, testing, validation, and implementation activities.
• Validate that reimbursement methodologies, fee schedules, rates, escalators, and payment provisions are reflected in systems.
• Lead root-cause analysis of reimbursement discrepancies and drive corrective actions.
• Provide operational leadership for significant payer payment disputes and recovery opportunities.
• Support enterprise governance and risk monitoring for Contract Compliance & Performance.

Education

Bachelor's degree in healthcare administration, finance, business administration, accounting, health information management, data analytics, or a related field

Master's degree preferred (MBA, MHA, MPH, or related)

Job description

Mount Sinai Health System seeks a Senior Director, Contract Compliance & Performance to lead the enterprise framework and drive value from payer contracts. You will guide operationalizing contract requirements and analytics across the organization.

You will coordinate with Managed Care, Revenue Cycle, IT, Finance, and clinical leadership, translating contracts into actionable requirements, dashboards, and controls to reduce risk and improve reimbursement.