Director, Managed Care Contracting

Company: Memorial Physician Practices
Location: Brentwood
Posted on: May 17, 2025

Job Description:

Who we are:At Lifepoint Health, we provide quality healthcare to rural communities. As a valued member of our team, you will be an integral part of a group working together to elevate Lifepoint's healthcare delivery network.Our network includes 60+ community hospitals, 60+ rehabilitation/behavioral health hospitals, and 250 additional sites of care across the United States.As an organization, we are dedicated to serving communities nationwide by providing exceptional care. We believe in the power of our talented teams and strive to create environments where employees find purpose and fulfillment.What you'll do:As a Director, Managed Care Contracting, you will beresponsible foradministering, coordinating, and negotiating managed care agreements for LifePoint Health's Managed Care Contracting Group. You will work in conjunction with hospital and managed care leadership to execute managed care plans to strategically position and grow revenue.Responsibilities:

• Oversee and participate in the development, negotiation, implementation, monitoring and management of all assigned facility, physician, ancillary, and value based managed care agreements
• Support the regional managed care leader in the development and execution of local, state, or region wide managed care rate and/or value-based strategies
• Develop and maintain relationships with insurance companies, employers, brokers, TPAs, and other key purchasers of health care as assigned by Managed Care leadership
• Monitor and analyze the cost and revenue impact of payer policy changes. The Director will be responsible for clearly communicating the broader organizational impact of these changes to payers and senior hospital leadership
• Coordinate with LifePoint's population health team and leaders of LifePoint's clinically integrated networks to evaluate, negotiate, and implement total cost of care, bundle, and other narrow network or value-based agreements.
• Analyze and monitor financial aspects of existing managed care contracts and make recommendations for contract renewals, renegotiations, or terminations. Make recommendations regarding participation or non-participation with new or existing agreements/payers.
• Support the development and execution of the annual managed care revenue budget planning process based on the rates and contract terms within the assigned agreements
• Execute contract terminations as necessary
• Review managed care legal contract language and negotiate language to meet agreed to parameters with legal counsel to lessen risk and improve operational efficiencies
• Coordinate with hospital and physician practice revenue cycle and physician enrollment groups to assure contract compliance and troubleshoot reimbursement and enrollment issues
• Grow internal relationships and work cross functionally within the LifePoint HSC & hospitals including group/hospital leadership, physician services, quality, marketing, communications, revenue cycle, population health, HITS, legal, and other departments as necessary
  What you'll need:
  • Education:Bachelor's Degree in Business, Healthcare, Mathematics, Engineering, Finance, or other quantitative field of study
  • Experience:5+ years of experience
  • Travel:Minimum overnight travel (up to 10%) by land and/or airWhy choose us:As a team member of the Health Support Center, our goal is to support those that are in our facilities who are interfacing and providing care to our patients and community members. Our focus is to attract, retain, and empower a diverse and determined workforce. Our mission statement is at the heart of who we are and what we do: "Making Communities Healthier." In this shared mission, we believe that our collective efforts will shape a healthier future for the communities we serve.Benefits:We offer an excellent total compensation package, including a competitive salary and benefits. Some of our benefits include 401k, flexible PTO, medical, dental, vision, tuition reimbursement, and an Employee Assistance Program. We believe that happy, healthy people have a passionate engagement with life and work and have designed our package to enhance your wellbeing.
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Keywords: Memorial Physician Practices, Clarksville , Director, Managed Care Contracting, Executive , Brentwood, Tennessee