Summary

SUMMARY:   Provides experienced managed care contracting, consulting and marketing services to LifeBridge Health (LBH) including, but not limited to, negotiating contracts, marketing LBH entities' services/products to payers, implementing managed care policies/procedures at each LBH entity and analyzing various LBH business projects.    *Qualified candidates should have recent and heavy experience in acute care hospital contract negotiations with insurance carriers.    RESPONSIBILITIES:  Negotiates and oversees implementation of managed care contracts for LBH entities, affiliates and HealthStar Medical Services, Inc. with managed care payers, employers and others. Prepares and/or reviews analysis of contract reimbursement terms. Performs detailed review of contract language. Negotiates contract terms and rates directly with payer representatives. Oversees monitoring and evaluation of managed care contract performance. Develops and maintains positive relationships with payers, LBH physicians and support staff, other LBH entities and departments, and other area health care facilities. Routinely contacts/meets payer representatives to discuss current and future plans of both parties. Interacts with LBH physicians and support staff as needed to address issues, problems, questions, and to explain new and existing contractual agreements. Works collaboratively and supports other LBH departments (i. e. Human Resources, Business Development, Revenue Cycle) to help resolve issues and answer inquiries. Consults with peers at other area healthcare facilities to discuss emerging payer issues affecting hospitals. Acts as an internal consultant to LBH executive staff, departments and committees on such areas as managed care, LBH Employee Health Plan and market opportunities. Communicates to and educates LBH executive team on managed care emerging trends/issues. Seeks and develops performance improvement opportunities for LBH. Participates on various taskforce workgroups (i. e. denials management) to address and mitigate problems/issues. Assists Chief Financial Officer in development and implementation of health system managed care strategic plans and initiatives. Reviews cost of care trends associated with the LBH Employee Health Plan. This includes maintaining the confidentiality of employee health plan paid claims data for the purpose of business operations and analysis in accordance with HIPPA guidelines and regulations. Provides ongoing supervision of Managed Care Department staff. Demonstrates effective team building. Holds weekly staff meeting to review status of ongoing projects and maintains open lines of communication. Keeps staff actively engaged in new and existing projects and tasks as needed. Encourages creative and independent thought processes in addressing issues and tasks. Interfaces with industry and regulatory agencies and representatives. Participates in industry taskforce workgroups as needed. Oversees Hospital's HSCRC alternative rate applications and related compliance processes, interfacing with Commission staff as appropriate. Monitors Federal and State regulatory and statutory developments. Uses contract modeling software to analyze the financial analysis impact of proposals and counteroffers and oversee the refinement of the contract management system ensuring accurate post-negotiation updates. Tracks, analyzes, and reports on relevant data and metrics for health system entities, providing actionable insights to inform decision-making. Strengthens and evaluates community partnerships with local employers, brokers, and other key stakeholders. Provides market and business intelligence to support leadership decision-making, informing strategic planning and resource allocation.

QUALIFICATIONS AND REQUIREMENTS:

7+ years of relevant experience Familiar with the use of contract modeling software Master's degree preferred (MA or MBA in Healthcare, Business or related field)

Additional Information

Who We Are:

LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to “improve the health of people in the communities we serve.” Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care.

What We Offer:

Impact: Join a team that values innovation and outcomes, delivering life-saving care to our youngest and most vulnerable patients.

Growth: Opportunities for professional development, including tuition reimbursement and developing foundational skills for neonatal critical care leadership and advanced certification.

Support: A culture of collaboration with resources like unit-based practice councils and advanced clinical education support — improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license.

Benefits: Competitive compensation (additional compensation such as overtime, shift differentials, premium pay, and bonuses may apply depending on job), comprehensive health plans, free parking, and wellness programs.

Why LifeBridge Health?

With over 14,000 employees, 130 care locations, and two million annual patient encounters, we combine strategic growth, innovation, and deep community commitment to deliver exceptional care anchored by five leading centers in the Baltimore region: Sinai Hospital of Baltimore, Grace Medical Center, Northwest Hospital, Carroll Hospital, and Levindale Hebrew Geriatric Center and Hospital.

Our organization thrives on a culture of CARE BRAVELY—where compassion, courage, and urgency drive every decision, empowering teams to shape the future of healthcare.

LifeBridge Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression. LifeBridge Health does not exclude people or treat them differently because of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression.