Director of Patient Care Services

Director Of Managed Care

The Director of Managed Care is responsible for developing, negotiating, implementing, and managing commercial, governmental, and value-based payer contracts to optimize reimbursement, support organizational strategy, and improve financial performance. This leader oversees the Managed Care department, partners with finance, revenue cycle, legal, and executive leadership, and develops payer strategies that enhance access, profitability, and long-term sustainability.

The Director supports organizational revenue goals through effective payer relationships, contractual agreements, and operational partnership. This role requires initiative, self-direction, leadership, and a team-oriented approach with the ability to translate information into targeted action plans that meet evolving organizational needs. The Director must build collaborative relationships with internal stakeholders and external partners, influence decision-making outside direct reporting lines, and perform other duties as assigned.

Responsibilities include providing executive leadership and strategic direction for managed care contractual relationships, developing and executing managed care strategies aligned with organizational goals, negotiating payer contractual agreements, reviewing reimbursement methodologies, partnering with FP&A Decision Support and Reimbursement teams to model reimbursement margins and financial impact, partnering with Revenue Cycle to monitor payer performance, denials, underpayments, contract compliance, and other contractual opportunities that improve revenue and reduce leakage, monitoring market trends and CMS regulations that may affect payer strategy, reimbursement, contract compliance, and provider enrollment operations, building positive relationships with key health plans through regular communications/meetings to support the organizational goals, and communicating managed care changes, policy updates, and strategic direction across the organization to support alignment and timely implementation.

Education: Bachelor's Degree - in Healthcare Administration, Finance, Business, Accounting, Economics, or related field - Required Upon Hire. MBA/MHA - Preferred.

Work Experience: 7-10 Years - progressive healthcare finance or managed care experience - Required. 3-5 Years - payer contract negotiation experience - Required. Experience with commercial Medicare Advantage and Medicaid Managed Care contracting. Experience in 340b DSH Sole Community Hospital Critical Access Hospital rural health clinics provider-based ad physician reimbursement.

About Us: Mosaic Life Care is a health care system in northwest Missouri. With a vision of transforming community health by being a life-care innovator Mosaic places the holistic needs of patients first by providing the right care at the right time and place offering high value and quality health care. Mosaic has a wide array of benefits to meet each employee's individual needs. Our benefits were designed by listening to people just like you. Mosaic also offers several perks with a focus on ensuring our employees feel valued including concierge services, employee lounge, wellness programs, free covered parking, free on-site and virtual health clinics, and many more. When paired with compensation and recognition, it is what continues to make us the employer of choice for employees at any stage of their journey.