Washington Hospital Healthcare System Job Title: Director, Managed Care Contracting Job Code: 714 Reports To: Vice President & Chief Revenue Officer Position Summary: The Director, Managed Care Contracting contributes to WHHS growth and profitability by providing contracting expertise and guidance on managed care contracts. This role coordinates commercial, Medicare Advantage, Medi‑Cal, Value‑Based, Medicare Shared Savings and other third‑party managed care contracts and payor relations for Washington Hospital, Washington Township Medical Foundation and DEVCO entities (surgery centers and ancillary entities). The Director oversees administration, review, financial analysis of managed care contracts, financial modeling and reporting for senior management, and manages payor relations, denial follow‑up and resolution activities. Job Responsibilities Negotiate managed care contracts, maintain strategic relationships, evaluate contracts, and serve as internal resource for contract interpretation. Conduct initial reading and financial analysis of managed care contracts for content, administrative issues and expected financial return. Evaluate financial performance of existing contracts and monitor the performance of new contracts, producing regular financial impact reports. Collaborate with Managed Care and Finance leadership to develop contract proposals aligned with WHHS strategies, goals, and objectives. Work with WHHS Strategy to support employer direct contracting, new service contracting, and strategic growth initiatives requiring managed care contracting support. Prepare historical and financial data to support contract negotiations and renewals. Disseminate contract details to all stakeholders, ensuring accurate and complete project information and analysis. Support WHHS RCM and compliance with price transparency initiatives. Maintain accuracy and completeness of all projects, information, and analyses. Assist senior management with decision‑making regarding managed care and strategic issues. Qualifications Education: Bachelor’s degree required (minimum 10 years of related experience); Master’s degree in health‑related field preferred. Experience: Minimum 7 years in managed care contracting or a related capacity within a health plan or hospital, including at least 5 years of experience managing and mentoring contract or payor‑relations representatives. Experience in an administratively responsible position with significant intra‑department work. Demonstrated interpersonal skills and ability to work with diverse groups at various organizational levels. Knowledge of legal terminology, governmental regulations, and legislative requirements. Background in managed care, finance, or patient accounting. Ability to perform financial analysis and managed care contracting financial modeling. Computer skills in financial modeling, Microsoft Office (Excel, PowerPoint), and system reports. Strong interpersonal skills, effective public speaking, and independent, creative work style. Proven ability to represent the organization in administrative functions. #J-18808-Ljbffr