Managed Care Contracting and Performance Advisor

Job Family: Strategy & Transformation Travel Required: Up to 10% Clearance Required: None What You Will Do: The Managed Care Contracting and Performance Advisor is responsible for strategic management, evaluation, negotiation, implementation, and ongoing performance monitoring of managed care contracts. This role partners closely with Finance, Revenue Cycle, Operations, Physician Services, and payer organizations to optimize reimbursement, mitigate contractual risk, improve operational performance, and maximize revenue opportunities across hospital and physician service lines. The position serves as a subject matter expert in managed care reimbursement methodologies, contract language interpretation, payer negotiations, and contract compliance, while driving initiatives that improve financial outcomes and payer relationships. Essential Duties and Responsibilities: Contract Evaluation and Analysis: Conduct comprehensive reviews and audits of existing managed care contracts to identify opportunities for reimbursement improvement, contract optimization, and renegotiation. Perform financial modeling and reimbursement analyses to assess the impact of proposed rate changes, contract amendments, and new payer arrangements. Evaluate contract language to identify operational, financial, and compliance risks. Assess reimbursement methodologies, payment policies, authorization requirements, carve-outs, and contractual obligations to ensure alignment with organizational objectives. D