Contract Manager Managed Care

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world. As a Contract Manager Managed Care, you will negotiate and renegotiate managed care contracts while overseeing and coordinating the administrative, legal, operational and financial issues related to contract negotiations. In this role, you will maintain a comprehensive payer and managed care intelligence database, develop responses to requests for proposals from managed care plans and facilitate the creation of managed care educational and training materials for payer contract services, physicians, office managers and other participating provider personnel.A caregiver in this position works remotely from 8:00 a.m. -- 5:00 p.m. and is required to meet with the team annually in Cleveland for a half-day, on-site meeting. To be considered for this role, candidates must reside in Ohio, Florida or Nevada.A caregiver who excels in this role will: Manage a defined range of payer agreements such as PPO's, ancillary agreements, physician contracts or other managed care agreements.Routinely update rates and contract terms.Assemble, coordinate and manage the contract negotiation team including legal, finance, payer contract services and operations.Prepare assessments of new payer relationships including a comparison of standard CCHS terms and contract objectives.Recommend updates to standard CCHS contracts and business terms as business environment dictates and strategies change.Propose alternate legal language.Coordinate contract changes suggested by CPP, hospitals, legal, risk, and UM/QA.Evaluate opportunities and financial terms for hospital and physician contracts.Maintain chronology of managed care proposals and counter proposals.Assess legal risks in the context of contract provisions.Draft responses and fulfill requests for additional information needed by managed care plans representatives.Complete the development of proposals in response to managed care plan request for proposals.Provide the strategic and financial judgment necessary to achieve profitable growth with payers.Review models that quantitatively evaluate the financial impact of proposals to hospital and physician practice managers.Support and participate in the continuous assessment and improvement of the quality of care and services provided.Participate in the development of the annual budget and assist in developing contracting goals, strategies, activity plans and projections.Work with marketing department to develop and promote new products as well as build revenue in existing products.Other duties as assigned.Minimum qualifications for the ideal future caregiver include: Bachelor's DegreeThree years of contracting experience in a payor, provider or other relevant contract setting including negotiation of financial/contract terms and development of contract languageWorking knowledge of leading-edge managed care methodologies and practicesWorking knowledge of managed care operations, physician office practices, as well as hospital admitting, billing, and utilization review operationNegotiation skills, outstanding analytical ability and financial skillsPC skills necessary with experience in Microsoft Office productsManaged care experienceExperience across multiple service lines (e.g., heart and vascular, transplant, women’s health).Health system–based managed care contracting experienceHands-on experience negotiating and managing health insurance contractsPreferred qualifications for the ideal future caregiver include:Master's Degree with a focus in healthcare finance, marketing, administration or related fieldBackground involving managed care contracting with health systems to include hospital, professional, ancillary servicesExperienced with Fee for Service and Value Based negotiations for Commercial, Medicaid, Medicare Advantage and Marketplace plan typesUnderstanding of Revenue Cycle and Managed Care Business OperationsPhysical Requirements:Ability to communicate and exchange accurate information. Ability to perform work in a stationary position for extended periods. Ability to work with physical records or operate a computer or other office equipment. In some locations, ability to travel throughout the hospital system. In some locations ability to move up to 25 lbs.Personal Protective Equipment:Follows Standard Precautions using personal protective equipment as required for procedures.Pay RangeMinimum Annual Salary: $69,600.00Maximum Annual Salary: $106,132.50The pay range displayed on this job posting reflects the anticipated range for new hires. A successful candidate’s actual compensation will be determined after taking factors into consideration such as the candidate’s work history, experience, skill set and education. The pay range displayed does not include any applicable pay practices (e.g., shift differentials, overtime, etc.). The pay range does not include the value of Cleveland Clinic’s benefits package (e.g., healthcare, dental and vision benefits, retirement savings account contributions, etc.).Job ID: 337054Employment Type: 8:00am-5:00pmJob Area: FinancePosted Date: 11/11/2026