Director of Managed Care and Contracting (51476)

Job Details

Job Location: Houston Head Office - Houston, TX 77070Position Type: Full TimeJob Category: Health Care

 

 Performance Home Medical has been a leader in providing quality products and services since 1995.

 

At Performance Home Medical (PHM), our patients come first. We use the latest technology with compassionate clinical support to empower individuals in managing their conditions, helping them live longer, healthier, and more independent lives.

 

We are seeking a dynamic, strategic, and results-driven Director of Managed Care and Contracting to lead and optimize our payer strategy and provider agreements. This key leadership role is responsible for developing, negotiating, and managing managed care contracts that align with our organization’s financial goals and patient care priorities. The ideal candidate will bring leadership qualities that resonate with the collaborative and mission-driven culture at Performance Home Medical, a leading provider of medical supplies.

 

This remote position provides support across our markets in Washington, Oregon, Idaho, and Texas.

 

POSITION SUMMARY: 

The Director of Managed Care and Contracting is responsible for developing, negotiating, and managing payor contracts to ensure optimal reimbursement and access for Performance Home Medical’s respiratory services. This role plays a critical part in shaping the company’s payor strategy, maintaining strong relationships with insurance partners, and ensuring compliance with regulatory and contractual obligations.

 

Job Duties and Responsibilities include the following. Other duties may be assigned.

 

Contract Strategy & Negotiation

• Lead the development and execution of managed care strategies aligned with business goals.
• Negotiate and manage contracts with commercial payors, Medicare Advantage, Medicaid HMOs, and other third-party payors.
• Evaluate reimbursement models and recommend improvements to optimize revenue.

Payor Relations

• Serve as the primary liaison with insurance companies and managed care organizations.
• Foster collaborative relationships to support favorable contract terms and issue resolutions.
• Develop and deliver compelling presentations on Performance Health’s chronic disease clinical programs.

 

Financial & Operational Oversight

• Analyze contract performance, utilization trends, and financial impact.
• Collaborate with finance and billing teams to ensure accurate reimbursement and claims processing.

 Compliance & Risk Management

• Ensure all contracts comply with federal, state, and industry regulations.
• Monitor changes in healthcare policy and payor requirements, adjusting strategies accordingly.

Leadership & Collaboration

• Partner with clinical, sales, and operations teams to align payor strategies with service delivery.

 

 

Qualifications

 

QUALIFICATION REQUIREMENTS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

 

Essential Skills: To perform the job successfully, an individual should demonstrate the following:

• Adaptability - Accepts and applies feedback. Adapts to changes in the work environment. (Different clinical settings, client changes, supervisor changes, etc.). Changes approach or method to best fit the situation within guidelines and direction from supervisor. Manages competing demands. (Prioritizing responsibilities)
• Professionalism - Arrives and begins work prepared and on time.  Keeps absences within guidelines. Schedules time off in advance. Keeps commitments.  Completes tasks within required guidelines. Displays positive outlook, pleasant manner, and professional appearance. Establis