Med-Metrix

Compensation

Full Description

Job Purpose The Vice President, Contract Management & Pricing will lead Med-Metrix’s enterprise contract management and pricing functions. This executive owns the accuracy, governance, maintenance, and QA of all hospital and physician pricing logic, oversees the contract management analyst team, and serves as the primary liaison between Contract Management, Product Strategy, and Software Development. This leader ensures consistent pricing methodologies across hospital and physician billing, oversees pricing QA, guides complex pricing solutioning, and supports Med-Metrix’s 3M partnership. Duties & Responsibilities Leadership & Operational Oversight • Lead the Contract Management & Pricing organization, providing direction, coaching, and performance management to contract management analysts • Own the loading, validation, and maintenance of all payer contracts, fee schedules, and pricing configurations for both hospital and physician billing • Ensure adherence to enterprise-wide pricing QA standards, validation protocols, and documentation requirements Pricing Strategy, QA, and Development Partnership • Partner with the CTO, Product Strategy, and Development teams to prioritize pricing-related roadmap items, configurations, data inputs, and merge logic enhancements • Review and validate all pricing logic, merge logic updates, and heatmap pricing outputs to ensure accuracy and compliance • Lead solution development for complex pricing scenarios, custom client requirements, governmental changes, and non-standard contract methodologies • Maintain and improve QA processes for HB and PB pricing across the enterprise 3M & Vendor Partnership Support • Support the management of Med-Metrix’s 3M partnership, including coordination of updates, technical requirements, and implementation validation • Stay current on 3M regulatory, clinical, and payment model updates and ensure all appropriate changes are reflected within pricing logic Client Implementation & Cross-Functional Collaboration • Oversee pricing validation during new client implementations, ensuring clean data loads, accurate pricing, and appropriate contract mapping • Collaborate with AR Valuation, AR Services, Underpayment Recovery, and Managed Care teams to ensure pricing alignment and respond to escalated contract/pricing inquiries • Communicate contract updates, methodology changes, and pricing impacts to internal stakeholders Governance, Reporting, & Compliance • Maintain enterprise contract repositories, pricing documentation, and version control • Develop KPIs and dashboards to monitor pricing accuracy, load times, and QA compliance • Ensure compliance with state and federal payment regulations, government pricing factors, and payer contract requirements • Other duties as assigned • Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards • Understand and comply with Information Security and HIPAA policies and procedures at all times • Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties Qualifications • Bachelor’s degree required; Master’s degree preferred • 10+ years of experience in managed care contract management, hospital/physician pricing, or revenue cycle analytics, with 5+ years in leadership roles • Deep knowledge of payer contract structures, pricing methodologies, government reimbursement, and contract interpretation • Experience partnering with development/product teams on requirements and product solutions • Proficiency in Microsoft Office Suite, with strong Excel and technical aptitude related to pricing logic and data validation • Ability to thrive in a fast-paced, technology-driven environment • Strong interpersonal skills, ability to communicate well at all levels of the organization • Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses • High level of integrity and dependability with a strong sense of urgency and results oriented • Excellent written and verbal communication skills required • Gracious and welcoming personality for customer service interaction Working Conditions • Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes. • Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. • Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress. • Work Environment: The noise level in the work environment is usually minimal. Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.