Director of Managed Care Contracting - Stony Brook University : Job Details

Director of Managed Care Contracting

Position Summary

Stony Brook Medicine is seeking an experienced and strategic Director of Managed Care Contracting to lead our Managed Care Contracting Team within the Department of Managed Care. This leadership role is responsible for the oversight, negotiation, and management of all Managed Care contracts for the health system, ensuring compliance with contractual obligations, State and Federal regulations, and alignment with organizational financial goals.

Under the direct supervision of the Assistant Director of Managed Care, the Director will oversee the daily operations of the Managed Care Contracting Team, ensure timely execution of contracts and amendments, manage contract databases and facility credentialing processes, and serve as a key liaison to internal departments including Patient Accounts, Business Office, Revenue Integrity, Finance, and Patient Access.

Duties of a Director of Managed Care Contracting may include the following but are not limited to:

• Lead and manage the daily operations of the Managed Care Contracting Team.

• Oversee and direct the negotiation, execution, and administration of all hospital, physician, and ancillary Managed Care contracts.

• Maintain accurate, up-to-date Managed Care contract databases and tracking tools.

• Timely review contract terms and upon renewal draft necessary language revisions to protect the organization's interests and mitigate risk.

• Ensure compliance with contractual obligations, including financial, operational, and facility credentialing requirements, within specified timeframes.

• Support internal operational departments by addressing contractual disputes, claim denials, and reimbursement issues.

• Participate in and support Joint Operating Committee (JOC) meetings, contract settlement discussions, and reimbursement escalations.

• Ensure compliance with Medicare and Medicaid reimbursement methodologies and stay current on commercial and government changes affecting the organization.

• Monitor and dispute Managed Care payer reimbursement policies or practices that breach contract terms, track resolution outcomes.

• Oversee facility credentialing process.

• Maintain comprehensive knowledge of applicable New York State regulations (DFS, DOH, New York Insurance Law, 10 NYCRR Part 98, New York Public Health Law Article 5, Article 28, Article 36, and Article 44, New York Education Law (§) 6527, Medicaid Managed Care Model Contact, CON regulations) federal regulations (ACA, 42 CFR Part 438, ERISA, CoPs, EMTALA, CLIA, HIPAA), and managed care industry standards (TJC, NCQA, URAC).

• Develop and implement contracting team policies, procedures, and workflow improvements.

• Prepare and present reports to leadership on contract status, financial impacts, and strategic opportunities.

Qualifications

Required Qualifications:

• Master's Degree (MS, MBA, MHA, MPH, or related).

• Minimum of five years of progressive managed care experience with a strong emphasis on hospital and physician contracting within a hospital, health system, physician group, or payer environment.

• Must have direct, hands-on experience negotiating and managing contracts for hospitals, health systems, physician groups, and ancillary services.

• Proven ability to independently lead complex payer contract negotiations, draft redline agreements, perform reimbursement analysis, and develop contracting strategies that align with organizational goals.

• At least three years of leadership or management experience.

• Strong knowledge of New York State, Federal, commercial payer reimbursement methodologies and Managed Care regulations.

• Proficiency in Microsoft Office applications (Excel, Word, PowerPoint) and experience managing contract management databases.

• Demonstrate excellent organizational and analytical skills.

• Proven ability to communicate and resolve issues effectively through both written and verbal communication.

Preferred Qualifications:

• Experience leading Managed Care contracting for an integrated delivery system with multiple hospitals, physician groups, and ancillary service lines.

• Familiarity with alternative payment models, including bundled payments, shared savings arrangements, capitation and other risk-based agreements.

• Experience managing facility credentialing processes.

• Working knowledge of Revenue Cycle operations, including prior authorization, denial management, and payer policy interpretation as it relates to Managed Care contracts.

• Proficiency with contract management systems and analytics tools used for contract modeling and financial analysis.

• Proven track record of successful payer relations and dispute resolution.

• Demonstrated ability to develop strategic contracting initiatives that improve financial performance and access to care.

• Experience presenting to or collaborating with leadership on managed care performance strategy.

Special Notes : Resume/CV should be included with the online application.

Posting Overview : This position will remain posted until filled or for a maximum of 90 days. An initial review of all applicants will occur two weeks from the posting date. Candidates are advised on the application that for full consideration, applications must be received before the initial review date (which is within two weeks of the posting date).

If within the initial review no candidate was selected to fill the position posted, additional applications will be considered for the posted position; however, the posting will close once a finalist is identified, and at minimal, two weeks after the initial posting date. Please note, that if no candidate were identified and hired within 90 days from initial posting, the posting would close for review, and possibly reposted at a later date.

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• Stony Brook Medicine is a smoke free environment. Smoking is strictly prohibited anywhere on campus, including parking lots and outdoor areas on the premises.

• All Hospital positions may be subject to changes in pass days and shifts as necessary.

• This position may require the wearing of respiratory protection, which may prohibit the wearing of facial hair.

• This function/position may be designated as essential. This means that when the Hospital is faced with an institutional emergency, employees in such positions may be required to remain at their work location or to report to work to protect, recover, and continue operations at Stony Brook Medicine, Stony Brook University Hospital and related facilities.

Prior to start date, the selected candidate must meet the following requirements:

• Successfully complete pre-employment physical examination and obtain medical clearance from Stony Brook Medicine's Employee Health Services

• • Complete electronic reference check with a minimum of three (3) professional references.

• Successfully complete a 4 panel drug screen

• • Meet Regulatory Requirements for pre-employment screenings.

• Provide a copy of any required New York State license(s)/certificate(s).

Failure to comply with any of the above requirements could result in a delayed start date and/or revocation of the employment offer.

*The hiring department will be responsible for any fee incurred for examination .

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Stony Brook University is committed to excellence in diversity and the creation of an inclusive learning, and working environment. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, familial status, sexual orientation, gender identity or expression, age, disability, genetic information, veteran status and all other protected classes under federal or state laws.

If you need a disability-related accommodation, please call the University Office of Equity and Access at (631)###-####.

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Visit our WHY WORK HERE page to learn about the total rewards we offer.

Stony Brook University Hospital, consistent with our shared core values and our intent to achieve excellence, remains dedicated to supporting healthier and more resilient communities, both locally and globally.

Anticipated Pay Range:

Anticipated Pay Range:

The salary range (or hiring range) for this position is $175000 - $192000 / year.

The above salary range represents SBUH's good faith and reasonable estimate of the range of possible compensation at the time of posting. The specific salary offer will be based on the candidate's validated years of comparable experience. Any efforts to inflate or misrepresent experience are grounds for disqualification from the application process or termination of employment if hired.

Your total compensation goes beyond the number in your paycheck. SBUH provides generous leave, health plans, and a state pension that add to your bottom line.

Job Number: 2502803

Official Job Title: : TH Associate Administrator

Job Field : Administrative & Professional (non-Clinical)

Primary Location : US-NY-Commack

Department/Hiring Area: : Medical Center Managed Care

Schedule : Full-time

Shift : Day Shift Shift Hours: : 9:00 am - 5:30 pm Pass Days: : Fri, Sat

Posting Start Date : Aug 4, 2025

Posting End Date : Nov 2, 2025, 11:59:00 PM

Salary: : 175### ####00

Salary Grade: : MP3

SBU Area: : Stony Brook University Hospital

Req ID: 2502803