Managed Care Contract Manager

Korn Ferry has partnered with our client for the role, Managed Care Contract Manager

Position Summary

We are seeking an experienced Managed Care Contract Manager to oversee the development, negotiation, implementation, and ongoing administration of managed care agreements with health plans, insurance companies, and other strategic healthcare partners.

This role will serve as a key liaison between internal stakeholders and external payers, ensuring contractual terms support organizational objectives while maintaining compliance with applicable healthcare regulations and payer requirements. The ideal candidate brings strong knowledge of managed care contracting, reimbursement methodologies, healthcare operations, and payer relationships, preferably within fertility, reproductive health, or other specialty healthcare services.

Key Responsibilities

• Lead the negotiation, execution, implementation, and maintenance of managed care and payer contracts.


• Review and analyze contract terms, including reimbursement rates, fee schedules, payment methodologies, authorization requirements, covered services, performance provisions, and termination language.


• Identify financial, operational, compliance, and contractual risks and recommend appropriate strategies to address them.


• Develop financial and reimbursement analyses to support contract negotiations and renewal discussions.


• Partner with Finance, Revenue Cycle, Legal, Compliance, Operations, Clinical, and other internal teams to ensure contracts are accurately implemented and administered.


• Maintain an organized repository of payer agreements, amendments, fee schedules, and related documentation.


• Monitor contract performance and payer compliance with negotiated terms.


• Track contract expirations, renewal dates, rate changes, amendments, and other key contractual milestones.


• Support resolution of payer disputes, reimbursement issues, claims-related concerns, and contractual discrepancies.


• Collaborate with Revenue Cycle and Finance teams to investigate underpayments and identify opportunities for improved reimbursement.


• Monitor changes in payer policies, reimbursement models, regulations, and industry trends that may affect contractual relationships.


• Prepare reports, dashboards, and presentations summarizing contract performance, reimbursement trends, and negotiation opportunities.


• Support the development of contracting strategies that balance patient access, operational requirements, and financial objectives.


• Build and maintain productive relationships with payer representatives and other external stakeholders.


• Ensure contract terms are communicated effectively to relevant internal teams and incorporated into operational workflows.


• Participate in special projects and strategic initiatives related to managed care, payer strategy, reimbursement, and network development.

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, Finance, Contract Management, or a related field preferred.


• 6+ years of experience in managed care contracting, payer relations, healthcare contracting, reimbursement, or a related healthcare field.


• Experience working with commercial health plans, managed care organizations, or specialty healthcare providers.


• Strong understanding of healthcare reimbursement methodologies, payer contracts, and managed care principles.


• Experience analyzing financial and contractual data.


• Strong negotiation, communication, and relationship-management skills.


• Excellent attention to detail and ability to interpret complex contractual language.


• Strong organizational and project-management skills with the ability to manage multiple agreements and deadlines simultaneously.


• Proficiency with Microsoft Excel and other business productivity tools.


• Ability to work collaboratively across clinical, financial, operational, legal, and administrative functions.

Preferred Qualifications

• Experience in fertility, reproductive health, women's health, behavioral health, or another specialty healthcare environment.


• Experience with value-based care, bundled payments, risk arrangements, or other alternative reimbursement models.


• Familiarity with healthcare regulatory and compliance requirements.


• Experience with payer contract management or contract lifecycle management systems.


• Knowledge of claims, revenue cycle, provider reimbursement, and network operations.

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