Director of Managed Care
The Remedy Group, San Jose, CA, United States
Regional Director of Managed Care - West Coast
What You’ll Do • Lead the evaluation, negotiation, and execution of managed care contracts across your region • Build and strengthen relationships with health plans and managed care organizations • Own the full contract lifecycle from strategy and negotiation through implementation and performance • Analyze reimbursement structures across Medicare, Medicaid, and commercial payers • Partner cross-functionally with leadership, billing, operations, and clinical teams • Identify trends, risks, and opportunities to improve contract performance and revenue outcomes • Support credentialing, payer communication, and issue resolution tied to contracting and reimbursement • Ensure alignment between contract terms and operational execution
What Success Looks Like • Strong payer relationships that drive competitive reimbursement • Contracts that are both financially and operationally optimized • Clear communication and alignment across internal teams • Improved revenue performance tied to strategic contracting decisions • A proactive approach to market changes, regulations, and payer dynamics
What You Bring • Experience negotiating and managing managed care contracts in healthcare • Strong understanding of reimbursement structures (Medicare, Medicaid, commercial) • Ability to analyze contract performance, denials, and appeals trends • A strategic mindset with strong attention to detail • Confidence working cross-functionally and communicating with leadership • Ability to adapt in a fast-paced, evolving environment
Additional Details • Remote (West Coast hours preferred) • Travel: ~25–30%
What You’ll Do • Lead the evaluation, negotiation, and execution of managed care contracts across your region • Build and strengthen relationships with health plans and managed care organizations • Own the full contract lifecycle from strategy and negotiation through implementation and performance • Analyze reimbursement structures across Medicare, Medicaid, and commercial payers • Partner cross-functionally with leadership, billing, operations, and clinical teams • Identify trends, risks, and opportunities to improve contract performance and revenue outcomes • Support credentialing, payer communication, and issue resolution tied to contracting and reimbursement • Ensure alignment between contract terms and operational execution
What Success Looks Like • Strong payer relationships that drive competitive reimbursement • Contracts that are both financially and operationally optimized • Clear communication and alignment across internal teams • Improved revenue performance tied to strategic contracting decisions • A proactive approach to market changes, regulations, and payer dynamics
What You Bring • Experience negotiating and managing managed care contracts in healthcare • Strong understanding of reimbursement structures (Medicare, Medicaid, commercial) • Ability to analyze contract performance, denials, and appeals trends • A strategic mindset with strong attention to detail • Confidence working cross-functionally and communicating with leadership • Ability to adapt in a fast-paced, evolving environment
Additional Details • Remote (West Coast hours preferred) • Travel: ~25–30%