Associate Director Managed Care Contracting

Department:

13212 Enterprise Corporate - Managed Health Clinical insights & Operations: Contract Management

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

8am-5pm, M-F, Remote

Variability in hours based on various project requirements

Pay Range

$51.05 - $76.60

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, business‑focused 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.
Bachelor's degree required, Master's 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 Bachelor's 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 Master's degree.

Our Commitment to You:

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 teammate's job

• Incenti