Manager, Managed Care Contracts

UMC Health System•Richmond, KY

1d•Onsite

About The Position

The Managed Care Contract Manager is responsible for the oversight, administration, and optimization of third-party payer contracts across the organization. This role leads contract lifecycle management, including auditing, execution, tracking, and renegotiating agreements to ensure optimal financial and operational performance. The position plays a critical role in developing and maintaining a comprehensive contract inventory, prioritizing contract activities, and identifying opportunities for improvement, including rate optimization, professional fee inclusion, and enhanced delegation language. Additionally, this role supports departmental workflow efficiency through the effective use of contract management tools, including Monday.com, to enhance reporting, tracking, and task management.

Requirements

Bachelor’s degree in business administration, Healthcare Administration, Finance, Accounting, Juris Doctor (JD) or related field required.
Minimum of four (4) years of experience in negotiating, implementing, or managing payer contracts.
Experience in healthcare systems, academic medical centers, or integrated delivery networks preferred.
Demonstrated experience with revenue cycle operations and payer contracting processes.
Certification by the Healthcare Financial Management Association (HFMA) must be obtained within 24 months of employment.
Knowledge of managed care principles, payer contracting, and reimbursement methodologies.
Strong negotiation, analytical, and problem-solving skills.
Ability to interpret and apply contractual and regulatory requirements.
Strong organizational and time management skills with ability to manage multiple priorities.
Proficiency in Microsoft Office Suite and healthcare data systems.
Ability to maintain professionalism and confidentiality in all situations.
Comfortability with presenting to and collaborating with executive leadership.

Nice To Haves

Master’s degree preferred.

Responsibilities

Develop and maintain a comprehensive managed care contract inventory, including status, renewal dates, and prioritization to support proactive contract management.
Conduct regular audits of payer contracts to ensure accuracy, compliance, and alignment with organizational standards and regulatory requirements.
Oversee the full lifecycle of managed care contracts, including drafting, review, coordination, execution, and ongoing administration.
Establish and manage a prioritized contract workplan that includes renewals, renegotiations, and identified opportunities for performance improvement.
Identify and implement opportunities to enhance contract value, including rate optimization, professional fee inclusion, and improved language delegation.
Become a subject matter expert of contract management software to manage workflows, track tasks, and develop reporting mechanisms that improve departmental efficiency and transparency.
Coordinate with executive leadership and internal stakeholders to facilitate contract execution and ensure alignment across departments.
Maintain and distribute accurate managed care contract information, including updates to internal resources such as intranet sites and documentation repositories.
Support long-term contracting strategies and organizational initiatives by monitoring contract performance and contributing to network participation and payer strategy decisions.