Director Managed Care

Gentiva • Vinings, GA

2d

About The Position

The Director, Managed Care is a key operational leader within Gentiva's Managed Care team, reporting to the AVP, Managed Care. This role is responsible for the day-to-day execution of Gentiva's payer contracting activity — managing active contracts, coordinating negotiations, tracking the contracting pipeline, and ensuring the operational integrity of the payer contract portfolio across hospice and palliative lines of business. The Director works in close partnership with the AVP to support strategic pipeline development and serves as the primary operational point of contact for payer-facing contracting activity and internal cross-functional coordination.

Requirements

• 5+ years of experience in managed care contracting, payer relations, or a related healthcare contracting role; experience in hospice, palliative care, home health, or post-acute care strongly preferred.
• Working knowledge of managed care contracting across Commercial, Medicaid, VA, and Medicare Advantage; familiarity with the operational and regulatory differences across each line of business.
• Strong organizational and project management skills; ability to manage multiple active contracting workstreams simultaneously with accuracy and attention to detail.
• Experience coordinating with legal teams on contract review and redline processes; comfort managing payer-facing communication through the execution process.
• Proficiency in Excel and contract or pipeline tracking tools; experience maintaining structured documentation across a large contract portfolio.
• Strong written and verbal communication skills; ability to communicate clearly with both internal stakeholders and external payer contacts.
• Bachelor's degree required; advanced degree or relevant certification in healthcare administration, health policy, or business preferred.

Nice To Haves

• Experience in hospice, palliative care, home health, or post-acute care strongly preferred.
• Advanced degree or relevant certification in healthcare administration, health policy, or business preferred.

Responsibilities

• Manage day-to-day contracting activity across the payer portfolio, including new contract submissions, redline coordination with legal, term negotiation support, and execution logistics.
• Maintain and update the team's contracting pipeline tracker, ensuring accurate status, next steps, and owner documentation for all active contracting efforts across Commercial, Medicaid, VA, and Medicare Advantage lines of business.
• Support the AVP in executing the strategic contracting pipeline roadmap — coordinating outreach, preparing submission packages, and managing payer follow-up to advance contracts through each stage of the process.
• Track contract expiration and renewal timelines across the existing portfolio; flag upcoming renewals to the AVP with sufficient lead time to avoid lapses in coverage.
• Serve as the primary operational owner of Gentiva's existing payer contract portfolio across Commercial (hospice), VA (hospice), Medicaid (hospice), and Medicare Advantage (palliative), maintaining accurate contract records, rate schedules, and term documentation.
• Support local operators with Home Health contract maintenance in relevant geographies, coordinating with operators and payers to ensure coverage is current and operationally aligned.
• Coordinate with payers on contract amendments, rate adjustments, administrative updates, and credentialing changes, ensuring timely resolution and documentation.
• Monitor contract performance and compliance; escalate issues requiring AVP involvement or legal review promptly.
• Manage Medicaid contracting activity at the state plan level, including room and board pass-through coordination and tracking of bid holder status changes across applicable markets.
• Support the transfer of acquired entities' Medicare Identification and provider agreements, and any additional Change of Ownership work, including payer notifications, contract assignments, and re-credentialing required to bring acquired entities into Gentiva's payer contract framework.
• Maintain organized tracking of CHOW progress by payer and market; provide regular status updates to the AVP and flag items at risk of timeline slippage.
• Support MA contracting activity for Empatia's palliative care program across existing and new markets, coordinating submission logistics and payer follow-up under the direction of the AVP.
• Coordinate with Gentiva's credentialing team on NP-level credentialing requirements associated with MA physician contracts, tracking credentialing status for each market.
• Maintain a market-by-market status tracker for Empatia MA contracting, aligned with branch launch timelines and the AVP's forward contracting roadmap.
• Serve as the primary internal liaison between the Managed Care team and legal, revenue cycle, credentialing, and operations on contracting-related matters.
• Coordinate with legal to submit contracts for review, track redline turnaround against defined internal SLAs, and manage document versions through execution.
• Partner with revenue cycle on contract loading, rate verification, and claims issue resolution tied to payer contract terms.
• Support preparation of materials for AVP and CSO reporting, including pipeline updates, portfolio status summaries, and CHOW progress reports.

Benefits

• Competitive Pay
• 401(k) with Company Match
• Career Advancement Opportunities
• National & Local Recognition Programs
• Teammate Assistance Fund
• Medical, Dental, Vision Insurance
• Generous Paid Time Off + 7 Paid Holidays
• Wellness Programs (Telemedicine, Diabetes Management, Joint & Spine Concierge Care)
• Education Support & Tuition Assistance
• Company-paid Life & Long-Term Disability Insurance
• Voluntary Benefits (Pet, Critical Illness, Accident, LTC)

What This Job Offers

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