Director of Managed Care Contracting

Akido

18h

About The Position

The Director of Managed Care Contracting manages Akido's payer and provider contracting activities, including drafting, negotiating, and administering managed care agreements. This role serves as a key liaison between Akido and health plan representatives, ensuring effective communication and timely resolution of contract-related issues. The Director of Managed Care Contracting works independently on complex contracting matters and collaborates with internal stakeholders to operationalize contract terms.

Requirements

Bachelor's degree required (healthcare administration, business, or related field preferred).
5+ years of managed care contracting experience, preferably with a health plan, IPA, MSO, or provider group in California.
Strong understanding of delegated model arrangements, capitation, and prepaid reimbursement structures.
Familiarity with California regulatory requirements (DMHC, Knox-Keene Act).
Ability to analyze, interpret, and summarize medical contracts and health maintenance agreements.
Excellent written and verbal communication skills, including ability to write reports, correspondence, and memos.
Strong organizational skills with ability to manage multiple contracts and deadlines.
Proficient in contract management systems and Microsoft Office.

Responsibilities

Analyze and review payer contracts to assist legal counsel with contract negotiations.
Draft, redline, and negotiate managed care agreements with payers and provider groups under delegated and non-delegated arrangements.
Manage the full contract lifecycle including execution, amendments, renewals, and terminations.
Act as liaison between payers and internal departments within Akido to ensure effective communication.
Facilitate problem resolution for issues that arise between Akido and payers, and coordinate with revenue cycle teams to address payment variance, denials, and other payment issues.
Represent Akido in JOC meetings with payers.
Provide written communication to Akido management to ensure applicable staff is properly notified of specific parameters as defined in contracts.
Coordinate with Finance and Legal departments to ensure timely and accurate data analysis on prepaid contracts.
Ensure contracts comply with regulatory requirements and applicable state and federal regulations.
Maintain contract database and ensure accurate documentation of all agreement terms, rates, and key dates.
Support special projects as requested by leadership.
Other duties as assigned.