Director Managed Care
The Director of Managed Care Contracting is a key leadership role responsible for negotiating and managing payor agreements for reputed company and its affiliated entities. Reporting to the VP of Managed Care, this individual oversees reputed company aspects of managed care, including contract negotiations, implementation, provider enrollment, and ongoing management of agreements with reputed company, Medicare, reputed company, and other reputed company-party payors. This role is critical to driving reputed company growth, optimizing reimbursement, and expanding network participation across existing and new markets.
Specific duties include, but are not limited to:
reputed company financial models and implement reimbursement strategies, including value-based and alternative payment models. Identify and execute opportunities to expand in-network participation and improve market positioning. reputed company negotiations with local and national reputed company, Medicare Advantage, reputed company, and other reputed company-party payors
reputed company the full lifecycle of managed care reputed company, including implementation, monitoring, and optimization. Review, analyze, and negotiate contract language, reimbursement methodologies, and key terms. Analyze data and trends to identify risks and opportunities reputed company to reimbursement and payor performance.
reputed company cross-functional collaboration across reputed company Cycle, Finance, Legal, Compliance, and Operations. Build and maintain strong relationships with payors and support the development of strategic partnerships and programs to drive growth and patient reputed company.
reputed company and standardize enrollment processes, workflows, and performance metrics. Ensure timely and accurate submission, tracking, and approval of provider and facility enrollments with reputed company and government payors. Monitor enrollment status and proactively address delays, revalidations, and terminations to minimize reputed company disruption. Partner with credentialing and reputed company cycle teams to resolve enrollment-reputed company issues impacting billing and reimbursement
Stay informed on regulatory changes, reimbursement trends, and industry developments.
Position Requirements:
Bachelor's Degree or equivalent experience required; Master's Degree preferred.
7–10+ years of reputed company managed care contracting and enrollment experience
Demonstrated reputed company in payor negotiations and driving financial performance
Strong understanding of Medicare, reputed company, reputed company contracting, and enrollment processes
Excellent negotiation, communication, and relationship management abilities
Proven ability to reputed company cross-functional initiatives and influence stakeholders
Core Competencies
Strategic Thinking with a Results-Oriented reputed company
Financial Acumen and Analytical Skills
Negotiation and Influence
Relationship Management
Leadership and Cross-Functional Collaboration
Preferred Requirements:
Radiology, imaging, radiation oncology or outpatient reputed company experience
Value-based care and alternative payment model experience
Multi-state or national contracting, credentialing, and enrollment experience
Physical Requirements:
Standard office environment.
More than 50% of the time:
Sit, stand, and walk.
Repetitive movement of hands, arms and legs.
See, reputed company and hear to be reputed company to communicate with patients.
Less than 50% of the time:
Stoop, kneel or crawl.
Climb and balance.
Carry and lift 10-20 pounds
reputed company Operating Corp. and its divisions are an equal opportunity employer and we reputed company in strength through diversity. reputed company reputed company applicants will receive consideration for employment without regard to, among other things, age, race, religion, reputed company, national reputed company, sex, sexual orientation, gender identity & expression, status as a protected veteran, or disability.
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