Senior Director, Payer Contract Administration
New
C
Connections Health SolutionsBehavioral Health
This is a fully remote position in these states: AL, AR, AZ, CA, CO, CT, DC, FL, GA, IA, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MT, NC, NJ, OH, OR, PA, RI, SC, TN, TX, UT, VA, WAFull-TimeDirector
Salary not disclosed
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Job Details
- Experience
- 8 – 12 years
- Required Skills
- Project ManagementBusiness DevelopmentPeople Management
Requirements
- Bachelor's degree required.
- 8 – 12 years of experience in managed care and/or a high-functioning provider organization.
- Extensive experience in contracting, business development, and new/existing market expansion.
- Demonstrated success in negotiating and executing high-impact payor contracts.
- Deep knowledge of Medicaid, government payor systems, and the complexities of contracting with risk-bearing entities.
- Experience working in cross-functional team structures.
- Strong project and people management skills.
- Ability to travel approximately 25% of the time.
- MBA or MHA from a leading program/institution preferred.
- 8+ years of managerial experience reporting to a senior level executive preferred.
- Experience contracting with or on behalf of health plans for behavioral health related services preferred.
Responsibilities
- Manage the payer contracting lifecycle process, including pre-negotiation preparation, market analysis, execution, and performance monitoring.
- Negotiate agreements that reflect market dynamics, reimbursement trends, and Medicaid-specific frameworks.
- Articulate the organization's clinical model and outcomes data to health plan partners and government agencies.
- Partner with business development, clinical operations, legal, and finance to support go-to-market and RFP activities.
- Establish and monitor key performance indicators (KPIs) for payer relationships to ensure revenue performance.
- Conduct periodic contract performance reviews to identify gaps and opportunities for improvement.
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