Operations Manager, Managed Care

Run day-to-day operations for governmental and managed care contracts to enhance revenues through commercial and payor partnerships. Implement and manage utilization management, quality, and risk coding programs while identifying gain sharing opportunities for network physicians. Proactively build relationships with physicians, colleagues, and payor contacts to position the network as a top performer and access first-to-market opportunities. Integrate pricing, contracting, and program development strategies to maximize volume and profitability, including annual contract reviews and vendor partnership management. Evaluate opportunities to recommend to physicians and senior management, ensuring regulatory compliance for clinical and financial integration programs.