Cleveland Clinic · 1 day ago
Assistant Director, Payer Contracting and Business Development
United States
Full-time
Remote
Director/Executive
10+ years expCleveland Clinic is recognized as one of the top hospitals in the nation, and they are seeking an Assistant Director for Payer Contracting and Business Development. This role involves developing and implementing payer contracting strategies, managing relationships with third-party payers, and leading business development efforts to enhance the organization's market presence.
Health CareHospitalMedicalNon Profit
Responsibilities
Analyze markets from a strategic perspective, develop managed care strategies and tactics by market, nationally and at the state level
Provide work direction and leadership to regional and national caregivers teams within MNS to support the following lines of business including but not limited to: Medicaid, transplants, centers of excellence, regional PPOs, and single case agreements
Develop and implement market and network services goals including but not limited to managed care contracting goals and objectives ensures their execution
Recommend and gain support from MNS leadership, institute leaders and operations to ensure optimal implementation of the business development and managed care contracting strategies
Maintain awareness of market, payer, and competitive managed care activities and adjust strategies accordingly
Work with contract managers, operations, and clinical caregivers to ensure effective implementation of new and renegotiated contracts and to resolve problem payer issues
Communicate effectively with leadership, operations, and contract managers on the status of contracting and problem payer issues
Review and negotiate contract language and pricing terms in accordance with budgetary objectives and policy and procedures to maximize benefit to the company
Represent the company to payers and regulatory authorities in matters related to payer account management. Manages not less than 1/3 of the net reimbursement from managed care payers
Effectively communicates trends and issues to corporate managed care through ad hoc communications, monthly and quarterly reports
Work with corporate managed care to recommend changes in contracting and reimbursement guidelines to ensure achievement of reimbursement maximization as it relates to managed care
Develop playbooks for contracting segments including but not limited to transplant, vision, dental, behavioral health, and value-based contracting to aid in the development of the contract managers and senior contract managers
Qualification
Required
Bachelor's degree in Finance, Accounting, Business, or Healthcare Administration or related field
Ten years healthcare management experience in a managed care environment
Extensive knowledge of healthcare planning, finance, marketing, reimbursement, operations, and related activities
Experience leading process improvement activities across cross functional teams and organization
Preferred
Master's degree
Experience managing contracts for regional systems offering comprehensive services
Experience working with various insurance plans and diverse healthcare services
Company
Cleveland Clinic
Cleveland Clinic is a non-profit medical center that combines clinical and hospital care with research and education. It is a sub-organization of Ashtabula Regional Medical Center.
10001+ employees
H1B Sponsorship
Cleveland Clinic has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (89)
2024 (78)
2023 (100)
2022 (60)
2021 (71)
2020 (46)
Funding
Current Stage
Late StageTotal Funding
$362.54MKey Investors
National Institutes of HealthNational Cancer InstituteAgency for Healthcare Research and Quality
2023-02-21Grant· $3.14M
2022-09-22Grant· $7.9M
2022-06-30Grant· $14.2M
Leadership Team
Delos Cosgrove
CEO & President
Tomislav Mihaljevic
President & Chief Executive Officer, Cleveland Clinic
Recent News
2026-01-14
2026-01-03
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