Senior Director, Managed Care Strategy & Analytics

Sturdy Memorial Hospital, Inc.; Attleboro (MA); On-site; USD 139,000 - 220,000; Full time

Job summary

The Sturdy Memorial Hospital, Inc. seeks a Health Director of Managed Care Contracting to lead strategy, negotiation, and monitoring of third-party contracts across the system.

You will partner with Revenue Cycle and Population Health to ensure hospital and physician groups are paid under various contracts and value-based arrangements. You will serve as the primary liaison with payers, shaping contracting strategy, monitoring payer performance, and driving improvements in reimbursement while

Qualifications

• Bachelor’s degree in Healthcare Administration, Finance, Business Administration or related field.
• Graduate degree is desirable.

Responsibilities

• Lead third‑party contracting across the system, including hospitals, physician group and value‑based arrangements. Lead contract negotiations with third party insurers to ensure hospital and physician groups are paid market competitive rates for services rendered.
• Collaborate with executive leadership to align network contracting strategies with organizational goals. Monitor market dynamics to help inform contracting strategy. Develop and execute contracting strategies that anticipate market shifts, payer policy changes, and regulatory developments.
• Build and maintain positive relationships with third party insurers ensuring transparency, accountability, and alignment with organizational priorities to foster collaboration and resolve issues effectively and to position Sturdy Health to be able to effectively negotiate on behalf of hospital and providers.
• Monitor and analyze third‑party payments to assure contract compliance. Monitor payer performance, utilization trends, and reimbursement outcomes to identify opportunities for improvement and risk mitigation. Ensure accurate pricing of claims through Strata contract configuration.
• Ensure compliance with federal, state, and accreditation requirements in all contracting activities.
• Provide staff awareness and education on contract parameters and changes. Communicate complex concepts clearly to executives, physicians, and cross‑functional partners.
• Serve as primary contact and resource regarding contract interpretation and other managed care reimbursement issues. Work with internal clients to resolve issues, recommend process improvements related to reimbursement issues, and recommend future contract changes to enhance reimbursement and overall contract performance.
• Work with the Population Health Team in the development, valuation, and tracking of all value‑based programs, including shared savings, bundled payments, downside risk, and capitation. Monitors performance programs, and risk arrangements with third party payers to meet strategic objectives that maximize financial performance.
• Work with Budget and Decisions Support Department to incorporate accurate projections / analytics to support hospital operations / strategic decisions. Perform / review analyses related to payer policy changes, regulatory updates, reimbursement shifts and to support negotiation strategy.
• Assist with monthly net revenue/accounts receivable valuation. Prepare year end revenue related General Leger entries and audit work papers. Respond to audit questions as appropriate.

Skills

Negotiation

Analytics

Relationship management

Provider payments

Healthcare law

Communication

Independent work

Confidentiality

Values alignment

Education

Bachelor’s degree in Healthcare Administration, Finance, Business Administration or related field

Graduate degree desirable

Job description

The Sturdy Memorial Hospital, Inc. seeks a Health Director of Managed Care Contracting to lead strategy, negotiation, and monitoring of third-party contracts across the system.

You will partner with Revenue Cycle and Population Health to ensure hospital and physician groups are paid under various contracts and value-based arrangements. You will serve as the primary liaison with payers, shaping contracting strategy, monitoring payer performance, and driving improvements in reimbursement while