Managed Care Director

This role leads contract negotiations with commercial payers, Medicare, Medicaid, concierge benefit managers, employers, provider networks, and health systems to maximize revenue, strengthen market position, and support practice growth. Success in this role requires building strong relationships with payer partners, practice leadership, and key stakeholders while supporting managed care strategies across multiple practices and service areas.

Overview:

The Managed Care Director is responsible for developing and executing payer contracting, reimbursement, and value-based care strategies for assigned practices within The US Oncology Network. This role leads contract negotiations with commercial payers, Medicare, Medicaid, concierge benefit managers, employers, provider networks, and health systems to maximize revenue, strengthen market position, and support practice growth.Success in this role requires building strong relationships with payer partners, practice leadership, and key stakeholders while supporting managed care strategies across multiple practices and service areas.

 

The Director serves as a strategic advisor to practice leadership, identifying opportunities to enhance reimbursement, referral relationships, and participation in innovative payment models, including value-based and risk-sharing arrangements. The role collaborates with cross-functional teams across McKesson and US Oncology to develop and implement payer strategies, alternative payment models, and performance initiatives that improve financial and quality outcomes. This is a hybrid positon- the ideal candidate will be able to travel between Pennsylvania Locations as well as Deleware Locations, only candidates who are local to these areas will be considered. 

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Key Responsibilities

Lead managed care contracting and negotiation strategies with payers, providers,
employers, and health systems.
Develop and execute payer, reimbursement, and value-based care initiatives aligned with
practice growth objectives.
Advise practice and organizational leadership on managed care trends, revenue
optimization, and market opportunities.
Establish and maintain relationships with key payer and provider stakeholders.
Support development and implementation of alternative payment models, including
value-based reimbursement, shared savings, and risk-based contracts.
Analyze financial and operational performance to evaluate contract effectiveness and identify
improvement opportunities.
Collaborate with operations, finance, pharmacy, revenue cycle, and business development
teams to achieve budget and performance goals.
Provide guidance on managed care contract review, reimbursement policies, and
payer-related operational processes.
Monitor industry trends, payer activity, and market conditions to support strategic planning.

 

 

Minimum Qualifications
Education
Bachelor's degree required.
Master's degree in Business, Finance, Healthcare Administration, or related field preferred.
Experience
10+ years of experience in managed care, payer relations, value-based care, healthcare
administration, oncology, or multispecialty practice operations.
Experience negotiating payer contracts and developing strategic payer relationships.
Experience with value-based care models, reimbursement methodologies, and healthcare
financial analysis.

Preferred Skills
Strong understanding of managed care, healthcare reimbursement, and provider operations.
Experience in oncology or specialty healthcare environments.
Executive presence with strong leadership, communication, and relationship-building skills.
Ability to influence stakeholders and collaborate across diverse teams.
Proficiency in public speaking, presentations, and remote facilitation.
Knowledge of Microsoft Office Suite and Salesforce.

Working Conditions
Hrybrid position with approximately 30% domestic travel- On-site attendance is required during onboarding payer meetings, practice leadership engagement, and other business needs payer meetings, practice leadership engagement, onboarding, and other business needs. The position supports multiple practices across different service areas and requires the ability to effectively partner with diverse teams while balancing the unique needs of each division.