Associate Director Managed Care Contracting Job at Advocate Health Care (Charlotte)

Associate Director of Optimized Care Solutions – Enterprise Corporate Accounts

As a member of Baxter’s sales team, you’ll be aligned to one of our global busin...

Location

United States , Deerfield; Chicago

Salary:

173600.00 - 238700.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

12+ years of relevant experience
Hospital or health system operational experience (e.g., nursing, informatics, clinical operations, or related) combined with demonstrated commercial experience in provider-facing roles (sales, business development, strategy)
Track record of building and influencing relationships at the C-suite / senior leadership level within provider organizations
Understanding of hospital operations, clinical workflows, decision-making hierarchies, and health system dynamics
Ability to translate clinical, operational, and financial perspectives to shape strategic enterprise dialogues
Strong executive presence, consultative communication skills, structured problem-solving ability, and negotiation acumen
Experience orchestrating cross-functional teams across complex organizations
Bachelor’s degree required
Willingness/ability to travel for executive meetings and customer site visits at least 50% of the time

Job Responsibility

Establish, nurture, and grow relationships with senior executives and stakeholders (CMO, CNO, CNIO, CNE, CPSE, COO, etc.)
Serve as Baxter’s primary strategic clinical liaison to health system leadership, securing trust and credibility at the clinical stakeholder enterprise level
Identify and prioritize system‑level opportunities (cross-portfolio, transformation initiatives) and align Baxter solutions to those opportunities
Co‑develop multi‑year, cross‑divisional account plans in concert with HSEs and Baxter internal teams
Lead executive dialogues focused on portfolio positioning, long-term partnership, and sophisticated solution alignment (beyond product selling)
Collaborate with internal functional teams (sales, marketing, medical affairs, service, contracting) to design and execute cohesive commercial plans
Support enterprise-level agreements, governance processes, business reviews, and executive briefings
Act as internal voice of the customer—escalating key insights, influencing prioritization of internal resources, shaping product or service enhancements
Stay abreast of trends in healthcare delivery, hospital operations, workforce pressures, digital integration, and system-level strategies
Mentor and promote exemplary enterprise selling behaviors, consultative engagement, and relational growth mindset

What we offer

Medical and dental coverage that start on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP), with the ability to purchase company stock at a discount
401(k) Retirement Savings Plan (RSP), with options for employee contributions and company matching
Flexible Spending Accounts
Educational assistance programs
Paid holidays
Paid time off ranging from 20 to 35 days based on length of service
Family and medical leaves of absence
Paid parental leave

Fulltime

Associate Director, IT Front-Line Care

The role of the Associate Director, IT, Front-Line Care (FLC) is to provide tech...

Location

United States , Deerfield, Illinois or Skaneateles, New York

Salary:

128000.00 - 252000.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

A bachelor’s degree in business administration or a related field such as technology, economics, computer science, data management, communication, marketing or statistics
10+ years’ experience working with business leadership in creating measured value of IT investment
5+ years of experience in commercial technologies supporting capabilities such as marketing enablement, sales enablement, contracting, customer experience, etc.
5+ years of experience in life sciences
5+ years of experience in building business cases (costs, benefits, assumptions)
Certified Business Relationship Manager (CBRM®) accreditation, PMP or MBA is preferred
Prior experience working in a highly matrixed, large organization preferred
Proven experience and understanding of the complete SDLC process including compliance, privacy and security aspects

Job Responsibility

Accountable for all aspects of IT services either provided and handled within the IT segment team or provided from any other group within the entire IT organization
Develop and drive IT strategies to align with a high impact business agenda supporting the business segment
Collaborate with vendors, industry consultants and senior company management to define information needs, develop cases and priorities, sustain service levels, and proactively leading business demands
Be a trusted advisor to help the business to construct relevant business cases for vital investments and the required change management activities
Understand and anticipate the direction of the business segment, find opportunities based on capability needs and make recommendations to support the desired future state outcome
Initiate and maintain a Function/Business Area capabilities roadmap by keeping current with the technological advancements and digital innovations within the subject matter area
Become a leader with vision by introducing different ways that technology can improve value in our pursuit operational improvements and revenue growth
Handle partner concerns process accordingly when delivery of services falls outside of the SLA

What we offer

Paid Time Off
Employee Heath & Well-Being Benefits
Continuing Education/ Professional Development
Support for Parents
Employee Assistance Program
Medical and dental coverage that start on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP)
401(k) Retirement Savings Plan (RSP)
Flexible Spending Accounts

Fulltime

Associate Director, IT Front-Line Care

The role of the Associate Director, IT, Front-Line Care (FLC) is to provide tech...

Location

United States , Deerfield, Illinois or Skaneateles, New York

Salary:

128000.00 - 252000.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

A bachelor’s degree in business administration or a related field such as technology, economics, computer science, data management, communication, marketing or statistics
10+ years’ experience working with business leadership in creating measured value of IT investment
5+ years of experience in commercial technologies supporting capabilities such as marketing enablement, sales enablement, contracting, customer experience, etc.
5+ years of experience in life sciences
5+ years of experience in building business cases (costs, benefits, assumptions)

Job Responsibility

Accountable for all aspects of IT services either provided and handled within the IT segment team or provided from any other group within the entire IT organization
Develop and drive IT strategies to align with a high impact business agenda supporting the business segment
Collaborate with vendors, industry consultants and senior company management to define information needs, develop cases and priorities, sustain service levels
Be a trusted advisor to help the business to construct relevant business cases for vital investments and the required change management activities
Understand and anticipate the direction of the business segment, find opportunities based on capability needs and make recommendations
Initiate and maintain a Function/Business Area capabilities roadmap by keeping current with the technological advancements and digital innovations
Become a leader with vision by introducing different ways that technology can improve value in our pursuit operational improvements and revenue growth
Handle partner concerns process accordingly when delivery of services falls outside of the SLA

What we offer

Paid Time Off
Employee Heath & Well-Being Benefits
Continuing Education/ Professional Development
Support for Parents
Employee Assistance Program
medical and dental coverage that start on day one
insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP)
401(k) Retirement Savings Plan (RSP)
Flexible Spending Accounts

Fulltime

Associate Director of Acorn Center for Early Education and Care

The Associate Director of Acorn Center for Early Education and Care is a member ...

Location

United States , Boston

Salary:

60000.00 - 73000.00 USD / Year

Boston Chinatown Neighborhood Center

Expiration Date

Until further notice

Requirements

A bachelor’s degree is required in Early Child Care or the Child Development field with a minimum of 3 years of supervisory experience
Department of Early Education and Care (EEC) Certifications of Lead Teacher Preschool, Infant-Toddler Teacher, Director I, and Director II are required
Must meet Department of Early Education and Care (EEC) health and background check requirements
Must be certified in First Aid and CPR within 6 months of employment
Proficiency in Microsoft Office and other related applications
Excellent organizational skills and ability to manage multiple tasks in a fast-paced environment
Strong interpersonal, relationship-building, communication, and collaboration skills
Experience with mentoring and coaching
Respect for differences and the ability to work well in a multicultural environment

Job Responsibility

Partner with the Director of Acorn Center in running the daily operation of the center
Serve as the primary on-site contact for the center administration, teachers, children, and families during the Director of Acorn Center’s absences
Provide support and assist the Director of Acorn Center in the center’s regulatory visits preparation (Department of Early Education and Care (EEC), National Association for the Education of Young Children (NAEYC))
Manage and work with the Director of Acorn Center on interviewing, hiring, and training new staff, and supervising and conducting the evaluations of all staff
Collaborate with and support the Assistant Director in maintaining daily staffing coverage and developing staff schedules to meet Department of Early Education and Care (EEC) teacher and staff ratio guidelines
Partner with the Family Engagement Coordinator in the recordkeeping of children and families following agency and contract regulations
provide center tours and orient new families to the program
advocate for families and children with special needs
and carry out all Boston Pre-K responsibilities
Partner with the Education Coordinator in observing teachers, assistant teachers, volunteers, and interns in the classrooms, and provide them with feedback

What we offer

Hiring bonus of $6000 available
Competitive compensation package
Comprehensive health, life, and disability coverage
Retirement plan with employer matching
Supportive time-off policy
Professional development

Fulltime

New

Manager Managed Care

This position is responsible for managing daily activities as assigned by System...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

Bachelor's Degree preferred

Job Responsibility

Assists the point person to the hospital leadership teams and business offices for the assigned CHRISTUS region(s) for all managed care related aspects, including contract performance and operational issues
Carries out appropriate managed care related education and training including roll out of new payor contracts
Assists in payor/plan dispute resolution projects or any other special projects
Responsible for coordinating payer credentialing & re-credentialing activities
Works with the hospital business offices with regard to tracking and reducing managed care denials and underpayments, including restitution or other prompt pay penalties
Knowledge of Federal and Texas general regulatory environment related to managed care and participates in legislative advocacy activities as appropriate
Monitor implementation managed care contracts for all CHRISTUS Health Providers
Develop payer performance and monitoring tools
Conduct data analyses/reports to the assigned System Director or Director on payments and operational issues associated with Managed Care contract language

Fulltime

New

Director, Care Management (RN or LCSW)

The Director, Care Management will mainly be responsible for the operational com...

Location

United States , Los Angeles

Salary:

135136.00 - 216218.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Bachelor's Degree in Nursing
Master's Degree in Social Work for Licensed Clinical Social Workers
Minimum of 7 years of Care Management experience including progressively responsible leadership experience facilitating quality/process improvement, updating policies/procedures with the latest regulatory and accreditation standards
At least 5 years of leading staff or supervisory/management experience
Minimum of 3 years of relevant Health Plan experience
Excellent verbal, written and presentation skills
Critical thinking skills
Ability to efficiently and effectively assimilate information and communicate clearly and promptly to key stakeholders
Ability to analyze and identify trends in reports to facilitate decision for enhancements to program
Proven effective leadership skills

Job Responsibility

Collaborating with the Medical Director, responsible for the operations, programming and oversight of internal L.A. Care's Care Management Department, collaborates with internal and external delegates and any operations associated with the Care Management department
Ensures the CM department performs the following: All contracts, regulations, applicable state and federal regulations, NCQA CM Certification, Management Services Agreements & Other Contracts
Oversees and monitors operational compliance with organizational standards, policies and procedures and regulatory requirements
Assures department meets all regulatory time frames on CM
Develops and implements departmental policies and procedures
Develops and maintains departmental statistical and performance reports
Develops, implements and monitors performance standards
Develops and maintains effective communication mechanisms at various levels of the organization and with external organizations
Develop and maintain departmental budgets in line with organizational goals
Assures appropriate staff support of Utilization Management and other relevant committees

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Value & Access Insights Associate Director

The Value and Access Insights Associate Director is responsible for analytics re...

Location

United States

Salary:

192418.75 - 260331.25 USD / Year

Amgen

Expiration Date

Until further notice

Requirements

Doctorate degree and 3 years of relevant experience OR Master’s degree and 5 years of relevant experience OR Bachelor’s degree and 7 years of relevant experience OR Associate’s degree and 12 years of relevant experience OR High school diploma / GED and 14 years of relevant experience
Prior experience in contracts and pricing, direct payer experience or value marketing and have a good foundational understanding of the US payer environment and a strong foundation in the U.S. healthcare market
Excellent conceptual problem-solving skills with demonstrated ability to bring structure to vaguely defined problems, pragmatic problem-solving approach, and manage execution
Exceptional written/oral communication skills and executive presence across functions and across different levels of leadership
Authoritative command of complexity and ambiguity
ability to see the big picture
ability to collect, digest and assemble information to enable relevant business analyses
Strong leadership skills with a demonstrated ability to influence different styles
8+ years of healthcare experience in the biopharmaceutical industry, health care, and/or strategy consulting with specific experience and expertise in coverage, access and reimbursement drivers impacting the biopharmaceutical industry
High degree of analytical and problem-solving skills

Job Responsibility

Define and develop road map for CAPAI with expansion into other therapeutic areas
Business ownership of one of the platforms, CAP-AI – Rollout / upgrades and expansion
Partner with Patient Access and Reimbursement (PAR) team and Brand Marketing teams to build and prioritize analytics and insights plan in support of PSP strategy
Provide strategic guidance and manage a global team in USA and AIN within V&A organization
Through detailed analysis, Monitor the current program objectives and provide recommendations to PAR SLT on the optimal design changes
Drive analytics / insights and integrate multiple data sources to identify potential impact of any policy changes from the government, market events like M&A and other interconnected events
Constructively challenge teams by providing disconfirming information and encouraging innovative problem solving
Understand pharmaceutical ecosystem and data sets including medial and pharmacy claims (ex. IQVIA LAAD, Symphony Claims), prescription (ex. IQVIA NPA), outlet (ex. IQVIA DDD)
Prepare, continuously refine and present periodic reports tracking product and portfolio performance of PSP programs against business objectives
Execute analytics plan to generate insights from various internal and external datasets based on detailed understanding of related datasets i.e Patient level claims data

What we offer

A comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts
A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan
Stock-based long-term incentives
Award-winning time-off plans
Flexible work models where possible

Fulltime

Associate Director, Value Assessment – Independent Physician Associations Vaccines- US WEST

Join the team protecting half a billion lives every year with next-gen science, ...

Location

United States , Remote

Salary:

148500.00 - 214500.00 USD / Year

Sanofi

Expiration Date

Until further notice

Requirements

Bachelor's degree required
5+ years of experience in market access, payer engagement, or health economics related function (Vaccines a plus)
Must have experience navigating health systems and Independent Physician Associations or other risk-bearing entities
Vast understanding of commercial payer reimbursement and risk-barring methodology
Financial experience, vaccines understanding
Strong understanding of financial analysis/economic modeling
Attention to building and maintaining customer relationships to achieve success
Demonstrates Executive Presence in all types of interactions, boardrooms, in-person & remote
Collaborates across functional, geographic, and company boundaries to meet mutual business objectives
Continually focuses on the performance and development of oneself and others to enhance the talent of the company

Job Responsibility

Engage with C-suite level decision makers across Risk-based organizations (RBO) and Independent Physician Associations the use of Sanofi portfolio
Maximize the understanding of the economic value of Sanofi Vaccines products and demonstrate the clinical and economic value to customers in a compelling way according to their financial, quality and clinical objectives
Develop and update targeting and profiling in the assigned geography
Identify the optimal IPAs and RBOs with the highest probability of success of engagement
Map key decision makers within the IPAs and RBOs, noting any overlaps with other Sanofi customers or providers
Continuously assess trends in risk-based contracting and alternative payment models that influence opportunities within IPAs and similar entities
Identify strategy and tactics to payers when appropriate
Develop engagement strategy and tactics based on sound rational using available data sources, the collective intelligence of cross-functional teams and learnings from external sources
Document and share insights from IPA and RBO engagements to help inform Sanofi’s broader Market Access strategy
Contribute to refining the value proposition for the different types of RBOs, including IPAs, shifting conversations from cost only to health economics analysis, models, budget impact models, reimbursement arguments and clinical efficacy

What we offer

Company car through the Company’s FLEET program
Wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs
At least 14 weeks’ gender-neutral parental leave

Fulltime

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Associate Director Managed Care Contracting

Job Description

Job Responsibility

Requirements

What we offer

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