Associate Director Managed Care Contracting

8am-5pm M-F Remote

Variability in hours based on various project requirements

Pay Range

The Associate Director Revenue Performance Optimization provides strategic and operational leadership to drive payer-specific revenue performance through advanced analytics payer policy interpretation and managed care contract expertise. This role leads a team responsible for identifying revenue risk and opportunity across the claims lifecycle translating complex payer rules and contract language into actionable insights and executing key initiatives that improve reimbursement accuracy reduce denials and enhance net revenue.

Key Responsibilities

Strategic Revenue Performance Leadership

• Partner with Revenue Cycle Managed Care Finance and Clinical stakeholders to identify and prioritize initiatives that improve payer yield and reduce revenue leakage.
• Serve as a subject matter expert in payer reimbursement behavior policy interpretation and contract-driven performance.

Payer Policy & Contract Analysis

• Oversee detailed analysis of payer policies coverage determinations reimbursement methodologies and payment rules to quantify financial impact.

• Interpret managed care contract language fee schedules payment carveouts and amendments to support accurate modeling and payment validation.
• Translate contract and policy requirements into operational guidance and analytic frameworks for the team.

Claims Data & Advanced Analytics

• Direct analysis and extraction of claims remittance and denial data from billing and analytics systems to assess payer compliance and performance.

• Drive development of dashboards reporting packages and trend analyses to monitor key revenue indicators.

Denials & Underpayment Performance

• Guide root cause analysis of payer denials and underpayments identifying systemic issues related to policy interpretation authorization coding documentation or billing.

• Support payer dispute escalation and managed care negotiation efforts through data-driven insights.

Team Leadership & Initiative Management

• Lead mentor and develop a team of analysts setting clear expectations priorities and performance standards.

• Manage multiple concurrent initiatives ensuring alignment with organizational goals and timely delivery of measurable outcomes.
• Establish best practices governance and documentation standards for revenue performance analytics.

Executive Communication & Stakeholder Engagement

• Prepare and deliver clear concise presentations to senior and executive leadership outlining revenue risks payer trends and strategic recommendations.
• Translate highly complex analytical findings into actionable businessfocused messages.
• Act as a key liaison between analytic teams and operational leaders.

Physical Requirements
Performs most work under normal office conditions; may include sitting for long periods of time standing walking using repetitive wrist/arm motion or lifting articles up to twenty-five pounds.

Education Experience and Certifications.
Bachelors degree required Masters degree preferred (MBA or MHA preferred). Minimum of 5 years experience as a contract negotiator with a large provider or 7 years small provider or payor experience as a contract negotiator with a Bachelors degree. -OR- Minimum of 3 years experience as a contract negotiator with a large provider or 5 years small provider or payor experience as a contract negotiator with a Masters degree.

Our CommitmenttoYou:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs competitive compensation generous retirement offerings programs that invest in your career development and so much more so you can live fully at and away from work including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications skills relevant experience and/or training

• Premium pay such as shift on call and more based on a teammates job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical dental vision life andShort- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g. full-time part-time per diem temporary etc.); please ask a Recruiter for more information during an interview.