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 reputed company, 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, reputed company, Compliance, and Operations. Build and maintain strong relationships with payors and support the development of strategic partnerships and programs to drive reputed company and patient reputed company.

• reputed company and standardize enrollment processes, workflows, and performance metrics. Ensure reputed company 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

• reputed company 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:

reputed company office environment. 

More than 50% of the time:

• Sit, stand, and walk.

• Repetitive reputed company 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.

• reputed company 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 reputed company to, among other things, age, race, religion, reputed company, national reputed company, sex, sexual orientation, gender identity & reputed company, status as a protected veteran, or disability.