At Inbound Health, we provide an enablement platform with full-stack capabilities and proprietary technology and analytics tools customized for hospital and skilled nursing at home. Our flexible partnership structure helps customers leverage their existing assets while filling the necessary gaps for program scalability. With over 6,000 patients served across 350+ primary diagnoses since May 2020, we enable our clients to deliver safe, coordinated, and patient-centric care. Our comprehensive approach integrates biometric monitoring, in-home nursing, virtual visits, and a reliable supply chain, prioritizing quality and safety.

The Manager of Managed Care Contracting will be responsible for supporting the development and execution of the company’s managed care strategy and contracting functions. This includes the successful development, implementation, and ongoing management of managed care contracts for hospital and skilled nursing facility (SNF)-level care at home services.

RESPONSIBILITIES:

Performance Management

• Manage a portfolio of contacts and provider relationships for hospital and SNF@home services
• Evaluate contact performance and makes recommendations with respect to new cost management opportunities
• Develop cost and utilization reports to share with payor and system partners
• Monitor health care marketplace and internal utilization trends to assess new opportunities for cost savings, alternate delivery models and financial risk sharing
• Supervise medical economics team/business function

Regulatory Compliance

• Responsible for monitoring compliance with contractual terms and conditions with system and payor partners
• Stay up to date with relevant healthcare regulations and insurance policies, ensuring compliance in actuarial practices and contributing to development of internal policies and procedures

Contract development

• Perform analyses, including risk assessments, pricing evaluations, trend analysis, and financial projections to support strategic decision-making and contract performance
• Develop models for bundled hospital and SNF-at-home services, incorporating variables such as patient acuity, reimbursement rates, and market dynamics to maximize revenue generation while ensuring affordability and competitiveness
• Support negotiations with health plans to secure favorable reimbursement rates, contract terms, and conditions for hospital at SNF at home services

Collaboration

• Collaborate with cross-functional teams, including finance, operations, and marketing, to develop strategic initiatives, support product development, and drive overall business growth

Reporting and Presentations

• Prepare and present contract reports and findings to senior management and stakeholders, conveying findings in a clear and concise manner.

Continuous Improvement

• Identify areas for process improvement, automation, and enhanced efficiency within the managed care contracting function, leveraging technological tools and industry best practices.

EDUCATION REQUIREMENTS:

• Bachelor’s Degree MHA or MBA preferred 

KNOWLEDGE & SKILLS REQUIREMENTS:

• Skilled in reporting, financial modeling & data analytics
• Knowledge of relevant regulatory requirements
• Understanding of contract development & negotiations
• Strong (verbal & written) communication & interpersonal skills 
• Negotiation skills (preferably within a hospital, medical group or similar healthcare environment)
• Detail-oriented, self-motivated, comfortable in ambiguity, results/deadline driven 

WORK EXPERIENCE REQUIREMENTS:

• BA + 5 years or Masters + 2 years of demonstrated experience working managed care and/or value-based contracting
• Experience with data analytics and financial modeling
• Experience with a healthcare provider organization
• Experience with contract negotiations

PHYSICAL REQUIREMENTS:

• Prolonged sitting
• Heavy computer usage

ADDITIONAL POSITION DETAILS:

• Position will have dual reporting to CMO & SVP, Customer & Growth
• Up to 10% travel

Salary Range:

 $85,000 - $130,000. Individual compensation is based on skill set, experience, qualifications, location, labor markets, and other job-related reasons.

What We Offer

• Medical, Dental & Vision
• 401(K) matching
• Paid Time Off including 10 paid holidays
• Short- & Long-Term Disability
• Life Insurance
• Wellness Stipend
• Paid Parental Leave
• Opportunities for growth & development
• And more

Inbound Health is proud to be an equal opportunity employer. Not only do we embrace diversity but we, at Inbound Health, are committed to building a team that represents a variety of backgrounds, perspectives, and skills to reflect the diverse identities, experiences, and geographies of the patients we serve. We do not discriminate on the basis of race, sex, age, handicap, religion, natural origin or any other basis of protected class and were prohibited by law.