Strategic Payer Contracting Director

MedStar Health; Columbia (MD); On-site; USD 114,000 - 220,000; Full time

Job summary

MedStar Health is seeking an experienced managed care executive to lead payer contracting and payer relations across our integrated system in Maryland. This senior role focuses on contract negotiation, reimbursement strategy, and securing partnerships with payers to support patient access and financial performance.

The ideal candidate brings deep knowledge of Maryland’s rate-regulated environment, strong negotiation skills, and a track record of improving contract outcomes across hospital,

Qualifications

• Bachelor's degree in business, healthcare administration, public health, finance, or related field required.
• Graduate degree in Business Administration, Public Health, Health Administration, or related discipline preferred.
• 5–7 years of progressively responsible experience in healthcare delivery systems, health insurance, payer contracting, or managed care.
• Demonstrated success negotiating complex healthcare contracts.

Responsibilities

• Lead the negotiation, implementation, monitoring, and evaluation of managed care agreements for hospital, institutional, ancillary, and professional services, including contract language, reimbursement rates, and alternative payment arrangements.
• Build and maintain strong payer relationships while serving as the primary resource for contract interpretation, policy clarification, reimbursement concerns, claims issues, and operational challenges.
• Collaborate with finance, revenue cycle, legal counsel, clinical leadership, case management, physician advisors, administrators, and billing partners to resolve payer-related issues and ensure successful contract implementation.
• Conduct market, financial, utilization, and competitive analyses to identify contracting opportunities, strengthen provider networks, increase managed care utilization, and support the development of new services.
• Lead interdisciplinary contracting initiatives, RFP responses, package-pricing arrangements, payer negotiations, managed care improvement plans, and other strategic projects.
• Oversee clinical denial and appeal strategies, evaluate payer medical policies and utilization-management requirements, and develop executive reports that track denial trends, reimbursement issues, contract performance, and improvement opportunities.
• Educate physicians, leaders, residents, office staff, and other stakeholders regarding payer policies, contractual changes, managed care trends, reimbursement requirements, and operational procedures.
• Assess payer satisfaction, coordinate improvement initiatives, and oversee delegated credentialing activities to support regulatory compliance, timely reimbursement, and positive payer relationships.

Skills

Payer contracting

Healthcare reimbursement

Contract negotiation

Payer operations

Maryland rate regulation

Education

Bachelor's degree

Graduate degree preferred

Job description

MedStar Health is seeking an experienced managed care executive to lead payer contracting and payer relations across our integrated system in Maryland. This senior role focuses on contract negotiation, reimbursement strategy, and securing partnerships with payers to support patient access and financial performance.

The ideal candidate brings deep knowledge of Maryland’s rate-regulated environment, strong negotiation skills, and a track record of improving contract outcomes across hospital,