Managed Care Contract Manager

The Christ Hospital Health Network•Norwood, OH

About The Position

The Managed Care Contract Manager manages payor contracts throughout their lifecycle, supporting contract negotiations, financial analysis, reimbursement optimization, and revenue integrity. As a member of the Payor Relations team, the role works closely with the Revenue Cycle team and uses data-driven insights to improve contract performance, support strategic negotiations, and maintain strong relationships with payor partners while ensuring alignment with the organization's managed care strategy. The manager oversees a portfolio of payor contracts with lower total charge volume, ensuring that contract language updates, amendments, and renewals align with the organization's managed care and pricing strategy. The position coordinates specialized transplant contracting initiatives and provides administrative oversight for Center of Excellence and bundled payment arrangements. It also modernizes contract documentation using CLM software or a virtual environment, and negotiates and executes Single Case Agreements for out-of-network scenarios. The role monitors agreement performance against expected net reimbursement, identifies revenue leakage and underpayments, and supports price transparency requests. It assists the Director of Contract Management with negotiation strategies and works with data analytics or decision-support teams to develop financial models forecasting the impact of proposed rate restructures, alternative payment models, and contract updates.

Requirements

Bachelor's degree in Healthcare Administration, Finance, Business Analytics, or a closely related professional discipline; alternatively, an associate degree and at least five years of equivalent verified experience in negotiation, contract management, or payor relations.
Three to five years of direct experience within a healthcare system, major provider group, or commercial payor environment.
Experience negotiating reimbursement and other agreements between healthcare organizations.
Proficiency in financial modeling, data analysis, and contract yield projections.
Advanced Excel capability.
Practical understanding of healthcare reimbursement models, including MS/APR-DRGs, APCs, fee schedules, value-based care programs, and other payment models.
Ability to translate complex technical or financial data into concise, actionable insights for leadership.
Ability to maintain strong relationships with payor representatives.

Nice To Haves

Master's degree in Business or Healthcare Administration.
Experience with analytics in a healthcare payor and provider relationship setting.
Experience digesting price transparency files, including JSON file formats.

Responsibilities

Oversee, optimize, and maintain an assigned portfolio of payor contracts with lower total charge volume.
Ensure contract language updates, amendments, and timely renewals align with the organization's managed care and pricing strategy.
Direct and coordinate specialized transplant contracting initiatives.
Provide administrative oversight for Center of Excellence and bundled payment arrangements.
Modernize contract documentation in CLM software or a virtual environment, recording important dates, major contract terms, contacts, and related information.
Ensure specialized, single-case, and small-payor agreements support the broader managed care fiscal framework.
Negotiate, structure, and execute Single Case Agreements for out-of-network situations where standard active contracts are not established.
Monitor, evaluate, and report on the post-implementation financial performance of assigned agreements relative to expected net reimbursement.
Identify, track, and escalate revenue leakage, systematic underpayments, and material deviations from negotiated contract terms.
Assist with price transparency data requests and use the information to support managed care contracting and pricing strategy.
Assist the Director of Contract Management in developing negotiation strategies through data-driven positioning reports, yield analyses, and historical performance reviews.
Coordinate with data analytics and decision-support teams to create financial models forecasting the impact of proposed rate restructures, alternative payment models, and contract updates.