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, strategic managed care professional to lead payer contracting and payer relations across our integrated healthcare system. This highly visible position serves as a trusted liaison among managed care organizations, hospital leadership, physicians, revenue cycle teams, finance, legal counsel, and billing partners.

The ideal candidate combines strong contract negotiation skills with a thorough understanding of healthcare reimbursement, payer operations,

Qualifications

• Bachelor’s degree in business, healthcare administration, public health, finance, or related field.
• Graduate degree in Business Administration, Public Health, Health Administration, or related discipline preferred.
• Five to seven years of experience in healthcare delivery systems, health insurance, payer contracting, or managed care.
• Demonstrated success negotiating complex healthcare contracts.
• Experience using information systems and data to strengthen oversight.
• Revenue cycle management experience preferred.

Responsibilities

• Lead the negotiation, implementation, monitoring, and evaluation of managed care agreements for hospital, institutional, ancillary, and professional services.
• 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

Contract negotiation

Payer relations

Data analysis

Stakeholder collaboration

Healthcare reimbursement

Communication

Verbal communication

Written communication

Education

Bachelor's degree

Graduate degree

Job description

MedStar Health is seeking an experienced, strategic managed care professional to lead payer contracting and payer relations across our integrated healthcare system. This highly visible position serves as a trusted liaison among managed care organizations, hospital leadership, physicians, revenue cycle teams, finance, legal counsel, and billing partners.

The ideal candidate combines strong contract negotiation skills with a thorough understanding of healthcare reimbursement, payer operations,