Director of Managed Care and Contracting (53989)

Performance Home Medical•Houston, TX

2d•Remote

About The Position

Performance Home Medical (PHM) has been a leader in providing quality products and services since 1995. At PHM, our patients come first. We use the latest technology with compassionate clinical support to empower individuals in managing their conditions, helping them live longer, healthier, and more independent lives. We are seeking a dynamic, strategic, and results-driven Director of Managed Care and Contracting to lead and optimize our payer strategy and provider agreements. This key leadership role is responsible for developing, negotiating, and managing managed care contracts that align with our organization’s financial goals and patient care priorities. The ideal candidate will bring leadership qualities that resonate with the collaborative and mission-driven culture at Performance Home Medical, a leading provider of medical supplies. This remote position provides support across our markets in Washington, Oregon, Idaho, and Texas. POSITION SUMMARY: The Director of Managed Care and Contracting is a senior leadership role responsible for developing, negotiating, and managing payor relationships and contracts across the organization’s service markets. This individual plays a pivotal role in ensuring patients receive uninterrupted access to high-quality care during periods of organizational change and growth, serving as a trusted liaison between the company and its managed care partners. The ideal candidate is a seasoned managed care professional who brings deep knowledge of payor reimbursement structures, a collaborative spirit, and the drive to build lasting relationships with payers, patients, and internal stakeholders alike.

Requirements

Bachelor’s degree in healthcare administration, business, or a related field required; advanced degree preferred.
7+ years of progressive experience in managed care contracting and payor relationship management.
Prior experience in respiratory therapy, home medical equipment (HME), or related healthcare services strongly preferred.
Demonstrated success negotiating complex managed care agreements with commercial and government payors.
Deep understanding of payor reimbursement methodologies, fee schedule structures, and managed care regulatory frameworks.
Exceptional negotiation skills with the ability to achieve favorable outcomes while preserving strong payor relationships.
Strong analytical abilities; proficient in interpreting data and translating insights into actionable strategy.
Excellent written and verbal communication skills; able to present complex information clearly to diverse audiences.
Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, SharePoint).
Highly organized with the ability to manage multiple priorities and competing deadlines.
Adaptability – Navigates change with professionalism; adjusts approach to fit evolving clinical, operational, and payor environments.
Professionalism – Consistently demonstrates reliability, punctuality, and a positive, solution-oriented attitude.
Commitment to Quality – Continuously pursues skill development and operational excellence; seeks feedback and improvement.
Teamwork – Builds team cohesion and places collective success above individual recognition.
Communication – Communicates clearly and persuasively in both written and oral formats; adapts messaging to the audience.
Organizational Development – Achieves KPI goals; builds stakeholder trust and maintains high levels of satisfaction.
Leadership – Delegates effectively, sets clear expectations, supports team through change, and provides meaningful recognition.
Travel up to 50% within assigned region/territory as needed.
Valid state driver’s license in state of residence; must meet Motor Vehicle policy requirements.
Reliable transportation required.

Nice To Haves

Advanced degree preferred.
Prior experience in respiratory therapy, home medical equipment (HME), or related healthcare services strongly preferred.

Responsibilities

Lead the negotiation, execution, and management of managed care contracts with commercial, Medicare Advantage, Medicaid, and other third-party payors.
Develop and maintain strong, trust-based relationships with payor representatives to ensure favorable contract terms and continuity of care.
Serve as the primary point of contact for payor escalations, audits, and contract renewals.
Monitor contract performance, reimbursement trends, and payor policy changes to proactively address risks and opportunities.
Champion patient continuity of care initiatives during transitions, acquisitions, or market changes, ensuring minimal disruption to patients and referring providers.
Collaborate cross-functionally with clinical, operations, and finance teams to align contracting strategies with patient care goals.
Identify and develop new payor relationships to expand network participation and market access.
Analyze reimbursement data, utilization trends, and payor performance metrics to inform negotiation strategies and organizational decision-making.
Prepare and present contract proposals, financial models, and managed care reports to senior leadership.
Stay current on regulatory changes, payor reimbursement methodologies, and industry best practices in managed care.
Provide guidance and oversight to managed care staff, delegating responsibilities appropriately and fostering a culture of accountability and continuous improvement.
Mentor team members and support their professional development and growth.
Build and maintain cross-departmental relationships to ensure organizational alignment on managed care objectives.