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Director - Reimbursement and Contract Analytics

$117k - $208k

Mount Sinai Health System

Description

MSHP seeks a Director of Reimbursement and Contract Analytics to lead the contract analytics function supporting MSHS managed care agreements across hospital/facility, physician, and ancillary services. This role is responsible for managing a team of analysts and overseeing the development, validation, and operationalization of contract models, rate sheets, and reimbursement analyses across the full contract lifecycle. 
The Director will establish and maintain the tools, processes, and governance required to support accurate contract modeling, implementation, and ongoing performance monitoring, including oversight of contract build and validation within systems. This role reports to the Senior Director of Contract Analytics and Reimbursement Strategy.
The Director ensures optimal results through strong team leadership, strong execution, and high employee engagement, while adhering to institutional policies and applicable regulatory requirements.

Responsibilities

Responsibilities

1.    Lead and oversee the contract analytics function supporting hospital, physician, and ancillary managed care agreements, ensuring alignment with organizational contract management and reimbursement strategy.
2.    Manage, mentor, and develop a team of contract analysts, including setting priorities, overseeing workload distribution, and ensuring high-quality, timely deliverables.
3.    Develop, implement, and standardize analytical tools and financial models to support contract modeling, reimbursement analysis, and rate sheet development.
4.    Oversee scenario modeling and rate sheet development to support payer negotiations and broader reimbursement strategy, including evaluation of proposed and counter-proposed contract terms.
5.    Ensure accurate creation, validation, and maintenance of finalized rate sheets for internal use and for contract build and implementation.
6.    Oversee contract implementation workflows, including submission, tracking, and validation of contract builds within contract management systems.
7.    Manage and monitor contract-related work queues and requests, ensuring timely resolution, appropriate escalation, and adherence to service expectations.
8.    Ensure integrity and accuracy across a large portfolio of payer contracts, including ongoing updates, version control, and routine maintenance.
9.    Direct and review ad hoc reimbursement and contract analyses to support business decisions and inform reimbursement strategy.
10.    Establish and enforce validation and quality assurance protocols to ensure all analyses and contract deliverables meet defined accuracy and quality standards.
11.    Identify and implement opportunities to improve and streamline modeling, reporting, and contract management processes to enhance efficiency and scalability.
12.    Partner with contracting, finance, IT, and analytics teams to support contract execution, data alignment, performance monitoring, and reimbursement strategy initiatives.
13.    Support development and delivery of reporting to track contract performance, key metrics, and financial outcomes.
14.    Maintain proactive communication with internal stakeholders, ensuring responsiveness, organization, and timely follow-up to keep deliverables on track.
15.    Develop and maintain standard operating procedures to ensure consistency in methodologies, tools, and documentation across the contract analytics function.
16.    Provide leadership through coaching, training, and performance management to build a high-performing team and support professional development.
17.    Manage departmental operations using data-driven problem-solving approaches, ensuring compliance with institutional policies and applicable regulatory requirements.
18.    Perform all other duties as assigned.

Collaboration and Leadership
Collaborates with other business units to understand strategic goals and promote an environment conducive to creativity, change and information exchange.  
Assists in the training, coaching, mentoring of staff in accordance with all internal policies and procedures. Communicates values, strategies, and objectives of department or division on a regular basis. Assigns accountabilities, delegate’s tasks and responsibilities as appropriate. 

Qualifications

Education and Experience

  • BA required, MBA or advanced business degree in related finance or health care discipline preferred.
  • Minimum 5 years of experience in managed care contracting, reimbursement, healthcare finance, or contract analytics
  • Demonstrated experience leading or managing analytical teams and workflows
  • Strong experience in financial modeling, reimbursement analysis, and contract analytics within a healthcare environment
  • Experience working with contract management and analytics tools and platforms 
  • Advanced Microsoft Excel and PowerPoint skills required; experience with SQL or other data tools preferred 
  • Strong written and verbal communication skills

Additional Skills and Qualities

  • Highly organized and detail-oriented, with a strong focus on accuracy and quality across all deliverables 
  • Strong analytical and problem-solving skills, with the ability to interpret complex data and identify actionable insights 
  • Proven ability to lead, develop, and motivate high-performing teams 
  • Strong organizational and project management skills, with the ability to manage multiple priorities and deadlines 
  • Ability to translate complex data into clear, actionable insights for a variety of stakeholders 
  • Effective collaborator with the ability to build relationships across contracting, finance, operations, and analytics teams 
  • Demonstrates sound judgment and decision-making using data-driven approaches 
  • Adaptable and effective in fast-paced, evolving environments 
  • Committed to continuous improvement, process optimization, and operational efficiency 
  • Provides clear direction, constructive feedback, and development support to team members

Non-Bargaining Unit, E01 - Partner MSO Services - MSH, Mount Sinai Hospital

Employer Description

Strength through Unity and Inclusion

The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai’s unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual.

At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next chapter in our history.

About the Mount Sinai Health System:

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 11 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.

Equal Opportunity Employer

The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization.

Compensation

The Mount Sinai Health System (MSHS) provides salary ranges that comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $117000 - $208000 Annually. Actual salaries depend on a variety of factors, including experience, education, and operational need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

Vacancy posted 18 days ago
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