Job Details

Are you looking to join a company based on excellence and love? Then this is the job for you!

ChristianaCare is one of the country's most dynamic healthcare organizations, centered on improving health outcomes, making high-quality care more accessible, and lowering healthcare costs. ChristianaCare includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (1,299 beds), a free-standing emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care, and women's health. It also includes the pioneering Gene Editing Institute and was rated by IDG Computerworld as one of the nation's Best Places to Work in IT. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. It is continually ranked by U.S. News & World Report as the Best Hospital. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.

ChristianaCare Offers

• Full Medical, Dental, Vision, Life Insurance, etc.
• Two retirement planning offerings, including 403(b) with company contributions
• Generous paid time off with annual roll-over and opportunities to cash out
• 12-week paid parental leave
• Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more!

About this Position

ChristianaCare is searching for a Manager of Payor Relations and Contract Management to negotiate and implement contracts within ChristianaCare's systems and internal contract compliance. This position will also manage the negotiations and relationships for an assigned portfolio of payer contracts and service line contracts. This role will also establish, develop, and maintain relationships with payor’ provider relations departments as well as provide contracting services, support and represent managed care payors for all enterprise-wide entities.

Some responsibilities include.....

Leads negotiations for Medical, Dental, Vision, Skilled Nursing, Transplant and Direct to Employer contacts within the managed care contract portfolio

Lead, in concert with Sr. Director of Contracting, the development and monitoring of Payer Center of Excellence opportunities, tracks all enrollment and application cycles, works with internal stakeholders to assure that CCHS actively pursues, manages, monitors and facilitates the development of Centers of Excellence relationships across payors with internal stakeholders

During major negotiations, provide support to negotiating team by evaluating draft contracts in compliance with company templates, reimbursement structure standards, and internal operational and clinical structures

Collaborate with finance to develop and maintain each respective organization’s financial contracting modeling system by ensuring contract rates are loaded and results are validated to enable the development and evaluation of various facility reimbursement models in new and existing markets of DE, MD, PA, and NJ

Responsible to maintain for finance and decision support DE, PA, MD, and NJ Medicare and Medicaid, Commercial and other lines of business fee schedules for physician contracts and ancillary services as reference for the development of comparative financial analyses

Collaborates with stakeholders across the organization including, but not limited to, finance, legal, population health management, clinical operations, and others to refine ChristianaCare’s approach to value-based care, identify capability gaps, and make recommendations on approaches to successfully operationalize these programs

Monitor successful implementation of value-based and quality programs and secure confirmations from Population Health teams that they have completed implementation task. Update Department members of successful implementation and completion timelines

Tracks and monitors Quarterly comparative market data monitoring Medicare and Medicaid and ACA payer markets in DE/PA/MD with updating and distributing member count data and quick reference reports. Provide trending information for interim and yearly comparisons of market movement.

Provides Annual and interim research of Medicare Advantage product offerings and changes by payer in DE/PA/NJ and maintains report of products and trending information.

Acts as a liaison and provide operational and interpretational guidance to CCHS departments (e.g. Medical Dental Staff, Revenue Cycle, Utilization Management) pertaining to third-party contracts

Monitors payer compliance to the integrity of payer contract language and payment policies

Provides resources and guidance to senior leadership as a subject matter expert on contract terms and payer policies and opportunities for revenue enhancement and new program development.

Provides research of national and regional payer value-based initiatives and program opportunities for various CCHS Service lines. Provide documentation and data to VP and Sr. Directors

Facilitate issue escalation processes with payers including internal and external meetings and joint operations committees for issues that have been unresolved by CCHS revenue cycle and/or clinical and operational teams.

Works collaboratively with internal clinical, health information management, revenue cycle and operational constituents to resolve issues impacting revenue integrity and compliance to contracts and payer policies to resolve payer audits and disputes.

Collaborate with leadership to shape organizational payer strategy

*****Please note, the full job specification for this position will be provided during the interview process.

Education and experience requirements:

• Bachelor’s degree strongly preferred; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience could be considered in lieu of a Bachelor’s degree. Clinical background is an asset. Payer work experience is an asset.
• Minimum six (6) years of provider-based reimbursement/contracting experience and/or payer-based reimbursement/contracting/payer relations experience, through managed care reimbursement review/management, consulting, or population health management is required
• Understanding of provider contracting and various reimbursement methodologies is required.
• Proven track record of experience with Hospital, physician, ancillary, bundle payment and other revenue cycle types of reimbursement
• Superior knowledge of payer claims processing and payors policies along with the associated operations and revenue impact
• Team player that enjoys collaborating across the enterprise, can articulate, explain and share knowledge within the department and is a high achiever and believer in the organizations mission and its success
• Ability to develop strong working relationships within a fast-paced, matrixed organization

Annual Compensation Range $135,720.00 - $217,172.80This pay rate/range represents ChristianaCare’s good faith and reasonable estimate of compensation at the time of posting. The actual salary within this range offered to a successful candidate will depend on individual factors including without limitation skills, relevant experience, and qualifications as they relate to specific job requirements.

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Post End Date

Sep 29, 2025

EEO Posting Statement

ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program. To learn more about our benefits for eligible positions visit https://careers.christianacare.org/benefits-compensation/