Astrana Health

Technology-enabled platform delivering value-based care

Director Hospital Contracting - CA Market

Business OperationsUpdated on Nov 13

Full-timeMonterey Park, CA, USA$135k - $160k /yrHybrid

About the Job

Requirements

A bachelor's degree in Business Administration, Healthcare Administration, Finance, or a related field is required; equivalent experience is considered.
At least 5 years of healthcare contracting experience, including significant direct negotiation experience with hospitals or health systems.
Experience negotiating managed care agreements and risk-based contracting arrangements.
Demonstrated success negotiating managed care agreements with hospitals and health systems.
Strong understanding of hospital reimbursement methodologies, including DRG, per diem, case rate, APC, carve-out, and value-based payment models.
Experience leading projects and teams in a managed care, health plan, MSO, IPA, or provider organization environment.
Experience with delegated risk, capitation, Restricted Knox-Keene (RKK), dual risk, global risk, MSSP, ACO, or other alternative payment arrangements.
Ability to analyze financial models, contract language, and reimbursement structures to support negotiations.
Knowledge of California managed care contracting and delegated healthcare models.
Advanced Microsoft Excel, Word, and PowerPoint skills.
Experience with EZ-CAP or similar healthcare administration and managed care platforms.

Responsibilities

Partner with the VP of Contracting to develop and execute hospital contracting strategies across the organization.
Lead negotiations and ongoing relationship management with hospitals, integrated delivery systems (IDS), academic medical centers, and other facility-based providers.
Develop and execute hospital contracting strategies that support network expansion, market competitiveness, affordability, and financial performance.
Analyze hospital utilization, reimbursement models, and financial performance to support contract negotiation strategies.
Negotiate complex facility agreements, including inpatient, outpatient, behavioral health, post-acute, and ancillary service arrangements.
Manage Division of Financial Responsibility (DOFR) agreements, hospital amendments, Letters of Agreement (LOAs), and corrective action plans with health plans and hospital partners.
Evaluate contractual language, reimbursement structures, risk allocation provisions, and regulatory requirements to mitigate organizational risk.
Serve as the primary contracting escalation point for hospital and health system partners.
Collaborate with Finance, Network Management, Operations, Claims, Configuration, and Business Development teams to implement hospital contract terms successfully.
Monitor hospital contract performance, identify opportunities for rate optimization, and address network access or financial performance concerns.
Support value-based and risk-sharing initiatives involving hospital systems and facility partners.
Prepare analyses and recommendations regarding hospital network strategy, reimbursement trends, financial impact, and market opportunities.
Lead and mentor contracting staff while overseeing contract workflow and negotiation priorities.
Perform other duties as assigned.

This role will partner closely with the VP of Contracting to develop and execute hospital contracting strategies across the organization. The Director will lead negotiations with hospitals, health systems, and facility-based providers, ensuring competitive reimbursement arrangements, network adequacy, and alignment with organizational growth objectives. This individual will serve as a subject matter expert in managed care contracting, hospital reimbursement methodologies, delegated risk arrangements, and complex facility agreements while collaborating with key stakeholders to optimize network performance and financial outcomes.

Lead negotiations and ongoing relationship management with hospitals, integrated delivery systems (IDS), academic medical centers, and other facility-based providers.
Develop and execute hospital contracting strategies that support network expansion, market competitiveness, affordability, and financial performance.
Analyze hospital utilization, reimbursement models, and financial performance to support contract negotiation strategies.
Negotiate complex facility agreements, including inpatient, outpatient, behavioral health, post-acute, and ancillary service arrangements.
Manage Division of Financial Responsibility (DOFR) agreements, hospital amendments, Letters of Agreement (LOAs), and corrective action plans with health plans and hospital partners.
Evaluate contractual language, reimbursement structures, risk allocation provisions, and regulatory requirements to mitigate organizational risk.
Serve as the primary contracting escalation point for hospital and health system partners.
Collaborate with Finance, Network Management, Operations, Claims, Configuration, and Business Development teams to ensure successful implementation of hospital contract terms.
Monitor hospital contract performance, identify opportunities for rate optimization, and address network access or financial performance concerns.
Support value-based and risk-sharing initiatives involving hospital systems and facility partners.
Prepare analyses and recommendations regarding hospital network strategy, reimbursement trends, financial impact, and market opportunities.
Lead and mentor contracting staff while overseeing contract workflow and negotiation priorities.
Other duties as assigned.

Education:

Bachelor's degree in Business Administration, Healthcare Administration, Finance, or related field; equivalent experience considered.

Experience:

5+ years of healthcare contracting experience with significant experience negotiating directly with hospitals or health systems.
Experience negotiating managed care agreements and risk-based contracting arrangements.
Demonstrated success negotiating managed care agreements against hospitals and health systems.
Strong understanding of hospital reimbursement methodologies including DRG, per diem, case rate, APC, carve-out, and value-based payment models.
Experience leading projects and teams within a managed care, health plan, MSO, IPA, or provider organization environment.
Experience working with delegated risk, capitation, Restricted Knox-Keene (RKK), dual risk, global risk, MSSP, ACO, or other alternative payment arrangements.
Proven ability to analyze financial models, contract language, and reimbursement structures to support negotiations.
Knowledge of California managed care contracting and delegated healthcare models required.

Knowledge, Skills, and Abilities

Have advanced Microsoft Excel, Word, and PowerPoint skills.
Have experience with EZ-CAP or similar healthcare administration and managed care platforms.

About the Company

Astrana Health

Technology-enabled platform delivering value-based care

Astrana Health runs a physician-focused, technology-enabled care platform that supports providers in delivering proactive, preventive, value-based care. Its end-to-end system coordinates care across affiliated networks, a management services organization, and primary, specialty, and ancillary clinics to help more than 20,000 providers and over 1.6 million Americans in value-based arrangements. How it works: the proprietary platform connects clinicians, patients, and care settings, enabling proactive care planning, care coordination, and efficient delivery of services in primary and specialty care. The company differentiates itself by combining a large provider network, an MSO, and clinics with a single tech platform to scale value-based care and improve patient experiences and outcomes rather than relying on fragmented, fee-for-service models. Its goal is to create a healthcare system that delivers better care, better experiences, and better outcomes for all.

Company size: 501-1,000
Company stage: Not listed
Total funding: Not listed
Headquarters: Alhambra, CA
Founded: Not listed

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