Performance Home Medical
Director of Managed Care and Contracting (51476)
Performance Home Medical, Houston, Texas, United States, 77246
Director of Managed Care and Contracting (51476)
Performance Home Medical
has been a leader in providing quality products and services since 1995. At
Performance Home Medical
(PHM), our patients come first. We use the latest technology with compassionate clinical support to empower individuals in managing their conditions, helping them live longer, healthier, and more independent lives. We are seeking a dynamic, strategic, and results-driven
Director of Managed Care and Contracting
to lead and optimize our payer strategy and provider agreements. This key leadership role is responsible for developing, negotiating, and managing managed care contracts that align with our organization’s financial goals and patient care priorities. The ideal candidate will bring leadership qualities that resonate with the collaborative and mission-driven culture at
Performance Home Medical , a leading provider of medical supplies. This
remote
position provides support across our markets in Washington, Oregon, Idaho, and Texas. Position Summary
The
Director of Managed Care and Contracting
is responsible for developing, negotiating, and managing payor contracts to ensure optimal reimbursement and access for
Performance Home Medical’s
respiratory services. This role plays a critical part in shaping the company’s payor strategy, maintaining strong relationships with insurance partners, and ensuring compliance with regulatory and contractual obligations. Responsibilities
Contract Strategy & Negotiation
Lead the development and execution of managed care strategies aligned with business goals. Negotiate and manage contracts with commercial payors, Medicare Advantage, Medicaid HMOs, and other third-party payors. Evaluate reimbursement models and recommend improvements to optimize revenue. Payor Relations
Serve as the primary liaison with insurance companies and managed care organizations. Foster collaborative relationships to support favorable contract terms and issue resolutions. Develop and deliver compelling presentations on Performance Health’s chronic disease clinical programs. Financial & Operational Oversight
Analyze contract performance, utilization trends, and financial impact. Collaborate with finance and billing teams to ensure accurate reimbursement and claims processing. Compliance & Risk Management
Ensure all contracts comply with federal, state, and industry regulations. Monitor changes in healthcare policy and payor requirements, adjusting strategies accordingly. Leadership & Collaboration
Partner with clinical, sales, and operations teams to align payor strategies with service delivery. Qualifications
Essential Skills
Adaptability - Accepts and applies feedback. Adapts to changes in the work environment. Changes approach or method to best fit the situation; manages competing demands. Professionalism - Arrives and begins work prepared and on time; maintains professional conduct and appearance. Commitment to Quality – Demonstrates competence, continuous learning, and pursuit of development opportunities. Teamwork – Builds positive team spirit and collaborates toward shared goals. Communication - Listens, communicates clearly, and presents data effectively. Organizational Development - Builds trust, maintains records, supports process improvements, and drives stakeholder satisfaction. Leadership Management - Delegates, sets expectations, and supports teams through change. Education and Experience
Bachelor’s degree in healthcare or business administration preferred, or related experience. 7+ years of managed care contracting and relationship management experience, preferably in respiratory or home medical equipment (HME) sectors. Strong negotiation, analytical, and communication skills. Deep understanding of payor reimbursement methodologies and regulatory frameworks. Other Skills
Language Ability: Read, analyze, and interpret complex documents; respond effectively to sensitive inquiries; create presentations and articles; make persuasive presentations on complex topics to management and public groups. Mathematical Ability: Analyze data. Reasoning Ability: Solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists; interpret a variety of instructions. Computer Skills: Proficient with Microsoft Office (Word, PowerPoint, Outlook, Chrome, Internet Explorer, SharePoint). Certificates, Licenses, Registrations
Valid State Driver’s license in residing state. Travel Requirements
Travel up to 50% as needed within region/territory. Have reliable means of transportation. Meet the requirements of our Motor Vehicle policy. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship. Job Details
Seniority level: Director Employment type: Full-time Job function: Health Care Provider Industries: Hospitals and Health Care
#J-18808-Ljbffr
Performance Home Medical
has been a leader in providing quality products and services since 1995. At
Performance Home Medical
(PHM), our patients come first. We use the latest technology with compassionate clinical support to empower individuals in managing their conditions, helping them live longer, healthier, and more independent lives. We are seeking a dynamic, strategic, and results-driven
Director of Managed Care and Contracting
to lead and optimize our payer strategy and provider agreements. This key leadership role is responsible for developing, negotiating, and managing managed care contracts that align with our organization’s financial goals and patient care priorities. The ideal candidate will bring leadership qualities that resonate with the collaborative and mission-driven culture at
Performance Home Medical , a leading provider of medical supplies. This
remote
position provides support across our markets in Washington, Oregon, Idaho, and Texas. Position Summary
The
Director of Managed Care and Contracting
is responsible for developing, negotiating, and managing payor contracts to ensure optimal reimbursement and access for
Performance Home Medical’s
respiratory services. This role plays a critical part in shaping the company’s payor strategy, maintaining strong relationships with insurance partners, and ensuring compliance with regulatory and contractual obligations. Responsibilities
Contract Strategy & Negotiation
Lead the development and execution of managed care strategies aligned with business goals. Negotiate and manage contracts with commercial payors, Medicare Advantage, Medicaid HMOs, and other third-party payors. Evaluate reimbursement models and recommend improvements to optimize revenue. Payor Relations
Serve as the primary liaison with insurance companies and managed care organizations. Foster collaborative relationships to support favorable contract terms and issue resolutions. Develop and deliver compelling presentations on Performance Health’s chronic disease clinical programs. Financial & Operational Oversight
Analyze contract performance, utilization trends, and financial impact. Collaborate with finance and billing teams to ensure accurate reimbursement and claims processing. Compliance & Risk Management
Ensure all contracts comply with federal, state, and industry regulations. Monitor changes in healthcare policy and payor requirements, adjusting strategies accordingly. Leadership & Collaboration
Partner with clinical, sales, and operations teams to align payor strategies with service delivery. Qualifications
Essential Skills
Adaptability - Accepts and applies feedback. Adapts to changes in the work environment. Changes approach or method to best fit the situation; manages competing demands. Professionalism - Arrives and begins work prepared and on time; maintains professional conduct and appearance. Commitment to Quality – Demonstrates competence, continuous learning, and pursuit of development opportunities. Teamwork – Builds positive team spirit and collaborates toward shared goals. Communication - Listens, communicates clearly, and presents data effectively. Organizational Development - Builds trust, maintains records, supports process improvements, and drives stakeholder satisfaction. Leadership Management - Delegates, sets expectations, and supports teams through change. Education and Experience
Bachelor’s degree in healthcare or business administration preferred, or related experience. 7+ years of managed care contracting and relationship management experience, preferably in respiratory or home medical equipment (HME) sectors. Strong negotiation, analytical, and communication skills. Deep understanding of payor reimbursement methodologies and regulatory frameworks. Other Skills
Language Ability: Read, analyze, and interpret complex documents; respond effectively to sensitive inquiries; create presentations and articles; make persuasive presentations on complex topics to management and public groups. Mathematical Ability: Analyze data. Reasoning Ability: Solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists; interpret a variety of instructions. Computer Skills: Proficient with Microsoft Office (Word, PowerPoint, Outlook, Chrome, Internet Explorer, SharePoint). Certificates, Licenses, Registrations
Valid State Driver’s license in residing state. Travel Requirements
Travel up to 50% as needed within region/territory. Have reliable means of transportation. Meet the requirements of our Motor Vehicle policy. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship. Job Details
Seniority level: Director Employment type: Full-time Job function: Health Care Provider Industries: Hospitals and Health Care
#J-18808-Ljbffr