Director - Reimbursement and Contract Analytics

MSHP seeks a Director of Reimbursement and Contract Analytics to lead the contract analytics function supporting MSHS managed care agreements across hospital/facility, physician, and ancillary services. This role is responsible for managing a team of analysts and overseeing the development, validation, and operationalization of contract models, rate sheets, and reimbursement analyses across the full contract lifecycle. 

The Director will establish and maintain the tools, processes, and governance required to support accurate contract modeling, implementation, and ongoing performance monitoring, including oversight of contract build and validation within systems. This role reports to the Senior Director of Contract Analytics and Reimbursement Strategy.

The Director ensures optimal results through strong team leadership, strong execution, and high employee engagement, while adhering to institutional policies and applicable regulatory requirements.

 

Responsibilities

1.    Lead and oversee the contract analytics function supporting hospital, physician, and ancillary managed care agreements, ensuring alignment with organizational contract management and reimbursement strategy.
2.    Manage, mentor, and develop a team of contract analysts, including setting priorities, overseeing workload distribution, and ensuring high-quality, timely deliverables.
3.    Develop, implement, and standardize analytical tools and financial models to support contract modeling, reimbursement analysis, and rate sheet development.
4.    Oversee scenario modeling and rate sheet development to support payer negotiations and broader reimbursement strategy, including evaluation of proposed and counter-proposed contract terms.
5.    Ensure accurate creation, validation, and maintenance of finalized rate sheets for internal use and for contract build and implementation.
6.    Oversee contract implementation workflows, including submission, tracking, and validation of contract builds within contract management systems.
7.    Manage and monitor contract-related work queues and requests, ensuring timely resolution, appropriate escalation, and adherence to service expectations.
8.    Ensure integrity and accuracy across a large portfolio of payer contracts, including ongoing updates, version control, and routine maintenance.
9.    Direct and review ad hoc reimbursement and contract analyses to support business decisions and inform reimbursement strategy.
10.    Establish and enforce validation and quality assurance protocols to ensure all analyses and contract deliverables meet defined accuracy and quality standards.
11.    Identify and implement opportunities to improve and streamline modeling, reporting, and contract management processes to enhance efficiency and scalability.
12.    Partner with contracting, finance, IT, and analytics teams to support contract execution, data alignment, performance monitoring, and reimbursement strategy initiatives.
13.    Support development and delivery of reporting to track contract performance, key metrics, and financial outcomes.
14.    Maintain proactive communication with internal stakeholders, ensuring responsiveness, organization, and timely follow-up to keep deliverables on track.
15.    Develop and maintain standard operating procedures to ensure consistency in methodologies, tools, and documentation across the contract analytics function.
16.    Provide leadership through coaching, training, and performance management to build a high-performing team and support professional development.
17.    Manage departmental operations using data-driven problem-solving approaches, ensuring compliance with institutional policies and applicable regulatory requirements.
18.    Perform all other duties as assigned.
 

Collaboration and Leadership
Collaborates with other business units to understand strategic goals and promote an environment conducive to creativity, change and information exchange.  
Assists in the training, coaching, mentoring of staff in accordance with all internal policies and procedures. Communicates values, strategies, and objectives of department or division on a regular basis. Assigns accountabilities, delegate’s tasks and responsibilities as appropriate. 
 

Education and Experience

• BA required, MBA or advanced business degree in related finance or health care discipline preferred.
• Minimum 5 years of experience in managed care contracting, reimbursement, healthcare finance, or contract analytics
• Demonstrated experience leading or managing analytical teams and workflows
• Strong experience in financial modeling, reimbursement analysis, and contract analytics within a healthcare environment
• Experience working with contract management and analytics tools and platforms 
• Advanced Microsoft Excel and PowerPoint skills required; experience with SQL or other data tools preferred 
• Strong written and verbal communication skills
   

Additional Skills and Qualities
 

• Highly organized and detail-oriented, with a strong focus on accuracy and quality across all deliverables 
• Strong analytical and problem-solving skills, with the ability to interpret complex data and identify actionable insights 
• Proven ability to lead, develop, and motivate high-performing teams 
• Strong organizational and project management skills, with the ability to manage multiple priorities and deadlines 
• Ability to translate complex data into clear, actionable insights for a variety of stakeholders 
• Effective collaborator with the ability to build relationships across contracting, finance, operations, and analytics teams 
• Demonstrates sound judgment and decision-making using data-driven approaches 
• Adaptable and effective in fast-paced, evolving environments 
• Committed to continuous improvement, process optimization, and operational efficiency 
• Provides clear direction, constructive feedback, and development support to team members
   

Non-Bargaining Unit, E01 - Partner MSO Services - MSH, Mount Sinai Hospital