Director of Managed Care

Director Of Managed Care

As a vital leader in Otterbein's mission to enrich individual life journeys for all, the Director of Managed Care will lead the organization's managed care strategy across post-acute and skilled nursing settings. This position serves as the internal and external expert on managed care contracts, payer relations, and value-based care initiatives. In collaboration with clinical, operational, and financial teams, the Director will drive financial performance, improve payer relationships, and implement processes to enhance managed care outcomes and revenue integrity.

Primary Duties And Responsibilities

• Lead day-to-day execution of the managed care strategy across all Otterbein locations.
• Serve as the organization's expert and primary contact for all managed care-related matters.
• Partner with local leaders to educate and guide on payer contracts, expectations, and authorizations.
• Participate in and support the appeal and denial management process.
• Act as the primary liaison to external entities including OASN and Kairos Health Systems.
• Negotiate and manage payer contracts to ensure favorable terms and performance metrics.
• Develop and maintain a reporting structure for managed care income and expense by payer.
• Deliver regular analysis and actionable recommendations to senior leadership.
• Build and maintain a comprehensive managed care contract library segmented by payer, location, and line of business.
• Standardize and automate managed care-related processes across the organization.
• Collaborate with IT and finance to build an automated dashboard integrating key metrics (e.g., carve-outs, denials, LOS).
• Partner with Marketing and Operations to identify and remove admission barriers related to payer contracts.
• Assist in preparing and executing Value-Based Purchasing and Quality-related measures.
• Analyze organizational needs to determine the most effective case management model (centralized vs. decentralized).

Experience & Qualifications

Benefits

Apply today and begin a meaningful career as a Director of Managed Care at Otterbein!