Description
About the Job
Position Summary:
MedStar Health is seeking an experienced Manager, Payer Contracting & Managed Care Relations to provide strategic leadership across payer contracting, payer relations, and managed care initiatives. This role serves as a key liaison between payers, clinical leadership, revenue cycle partners, and operational teams, ensuring that payer agreements support MedStar Health's clinical mission, financial performance, and growth strategy.
In this highly visible role, you will lead complex payer negotiations, oversee contract implementation, resolve payer-related issues, and help shape managed care strategies across one of the region's leading integrated health systems.
Primary Duties and Responsibilities:
Lead payer contracting and payer relationship management, including negotiation of rates, contract language, carve-outs, network participation, and alternative reimbursement arrangements.
Serve as the primary liaison between payers, clinical leaders, revenue cycle, and operations, resolving payer-related clinical, operational, and claims issues.
Analyze and monitor managed care contracts, market trends, and regulatory data to assess performance, identify risk, and support strategic decision-making.
Oversee the implementation, maintenance, and compliance of institutional and professional payer contracts, including delegated credentialing activities.
Lead responses to payer RFPs and collaborate with internal stakeholders to promote MedStar Health services and strengthen managed care utilization.
Drive managed care improvement initiatives, including denial management strategies, payer satisfaction assessment, and interdisciplinary collaboration to improve financial and operational outcomes.
Education
Bachelor's degree in a related field required
Master's degree in Business Administration, Public Health, Health Administration, or related field preferred
Experience
7 years of progressively responsible experience in:
Healthcare delivery systems
Health insurance managed care
Payer contracting and negotiations
Successful experience in using information systems to enhance administrative and operational control
successful track-record in negotiating complex contracts required or Experience with revenue cycle management preferred
Strong understanding of healthcare provider networks and managed care contracting structures
Knowledge of Maryland's rate-regulated environment and HSCRC framework
Understanding of reimbursement models, financial incentives, and evolving managed care products
Ability to analyze contract language, financial terms, and regulatory requirements
Strong problem-solving skills with the ability to work independently and influence outcomes
Proven ability to collaborate across clinical, financial, and operational teams
Excellent verbal and written communication skills
Ability to manage multiple complex initiatives with minimal supervision
This position has a hiring range of
USD $114,004.00 - USD $219,960.00 /Yr.
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