Director Managed Care

Akumin

1d

About The Position

The Director of Managed Care Contracting is a key leadership role responsible for negotiating and managing payor agreements for Akumin and its affiliated entities. Reporting to the VP of Managed Care, this individual oversees all aspects of managed care, including contract negotiations, implementation, provider enrollment, and ongoing management of agreements with commercial, Medicare, Medicaid, and other third-party payors. This role is critical to driving revenue growth, optimizing reimbursement, and expanding network participation across existing and new markets. Specific duties include, but are not limited to: Develop 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. Lead negotiations with local and national commercial, Medicare Advantage, Medicaid, and other third-party payors Oversee the full lifecycle of managed care contracts, 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 related to reimbursement and payor performance. Lead cross-functional collaboration across Revenue Cycle, Finance, Legal, Compliance, and Operations. Build and maintain strong relationships with payors and support the development of strategic partnerships and programs to drive growth and patient access. Develop and standardize enrollment processes, workflows, and performance metrics. Ensure timely and accurate submission, tracking, and approval of provider and facility enrollments with commercial and government payors. Monitor enrollment status and proactively address delays, revalidations, and terminations to minimize revenue disruption. Partner with credentialing and revenue cycle teams to resolve enrollment-related issues impacting billing and reimbursement Stay informed on regulatory changes, reimbursement trends, and industry developments.

Requirements

• Bachelor's Degree or equivalent experience required; Master's Degree preferred.
• 7–10+ years of progressive managed care contracting and enrollment experience
• Demonstrated success in payor negotiations and driving financial performance
• Strong understanding of Medicare, Medicaid, commercial contracting, and enrollment processes
• Excellent negotiation, communication, and relationship management abilities
• Proven ability to lead cross-functional initiatives and influence stakeholders
• Strategic Thinking with a Results-Oriented Mindset
• Financial Acumen and Analytical Skills
• Negotiation and Influence
• Relationship Management
• Leadership and Cross-Functional Collaboration

Nice To Haves

• Radiology, imaging, radiation oncology or outpatient healthcare experience
• Value-based care and alternative payment model experience
• Multi-state or national contracting, credentialing, and enrollment experience

Responsibilities

• Develop 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.
• Lead negotiations with local and national commercial, Medicare Advantage, Medicaid, and other third-party payors
• Oversee the full lifecycle of managed care contracts, 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 related to reimbursement and payor performance.
• Lead cross-functional collaboration across Revenue Cycle, Finance, Legal, Compliance, and Operations.
• Build and maintain strong relationships with payors and support the development of strategic partnerships and programs to drive growth and patient access.
• Develop and standardize enrollment processes, workflows, and performance metrics.
• Ensure timely and accurate submission, tracking, and approval of provider and facility enrollments with commercial and government payors.
• Monitor enrollment status and proactively address delays, revalidations, and terminations to minimize revenue disruption.
• Partner with credentialing and revenue cycle teams to resolve enrollment-related issues impacting billing and reimbursement
• Stay informed on regulatory changes, reimbursement trends, and industry developments.

What This Job Offers

• Job Type: Full-time
• Career Level: Director