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Regional Vice President, Managed Care Contracting
Company : Prime Healthcare Services
Location : Aurora, IL, 60506
Job Type : Full Time
Date Posted : 12 January 2026
Overview
Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation’s leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!
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Responsibilities
The Regional VP, Managed Care will develops and implement the managed care strategies for the organization. Develops and implements alignment models such as pay for performance, bundled payments and various forms of risk contracting. Negotiates and administers contracts with managed care payers. Responsible for planning, evaluating, and implementing the various managed care programs through the negotiation of contracts with various Managed Care entities.
Key Responsibilities & Duties:
- Assesses and structures rate reimbursement levels for Managed Care Contracts.
- Develops relationships with Governmental Agencies and Managed Care Entities.
- Reviews, monitors, and disseminates changes with regard to Managed Care plan policy and provider manual changes.
- Negotiates Medicaid Contracts and Supplemental Funding.
- Assists Finance Department in projects assigned and disproportionate share.
Qualifications
EDUCATION, EXPERIENCE, TRAINING
Required qualifications:
1. At least 10 years related experience.
2. Minimum of Bachelor's degree required.
3. Master's degree in related field preferred.
4. In depth knowledge of managed care concepts, practices and procedures.
5. Strategic thinker, goal oriented, ability to work independently.
6. Excellent communication and presentation skills.
Preferred qualifications:
1. Payer and provider experience preferred.
Pay Transparency
Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $134,160 to $194,313 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
Employment Status
Full TimeShift
DaysEqual Employment Opportunity
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
Chicago, IL
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Frequently asked questions
In Aurora, IL, this role shapes payment structures by negotiating risk contracts and pay-for-performance models, directly impacting how managed care organizations reimburse providers. It requires strategic foresight to align local healthcare economics with broader managed care trends, ensuring sustainable reimbursement frameworks.
Success hinges on visionary strategy, negotiation acumen, and deep managed care expertise. This role demands the ability to independently drive complex contract negotiations while fostering relationships with payers and government agencies, differentiating it from operational or clinical healthcare leadership roles.
Professionals often advance to senior executive roles such as Senior Vice President of Healthcare Operations or Chief Network Officer, leveraging their expertise in contract negotiation, risk management, and payer relations to influence system-wide strategic decisions.
Aurora's healthcare market includes diverse payer mixes and regulatory environments, requiring careful navigation of Medicaid contracts and supplemental funding. Local competition and evolving managed care policies demand precise contract structuring to optimize reimbursement.
While not mandatory, certifications like Certified Managed Care Professional (CMCP) or credentials in healthcare finance and strategic contracting are advantageous locally, signaling expertise in navigating Illinois’ managed care regulations and payer landscapes.
Prime Healthcare leverages this role to align payer-provider contracts with its expansive hospital network, ensuring managed care strategies support patient volume growth and financial goals across multiple states, including Aurora, IL.
The competitive pay range of approximately $134,000 to $194,000 annually mirrors the role’s complexity, including high-stakes negotiations and strategic program development, combined with comprehensive benefits tailored for senior healthcare executives.
By structuring favorable contracts and managing risk arrangements, the VP directly influences revenue cycles and clinical alignment, optimizing both reimbursement rates and care delivery efficiency across Prime Healthcare’s facilities.
Aurora’s growing healthcare market creates strong demand for experienced executives skilled in managed care contracting, with competition driven by expanding hospital networks and payer complexity requiring nuanced negotiation expertise.
Successful negotiation involves deep understanding of state-specific Medicaid policies, leveraging supplemental funding opportunities, and maintaining collaborative government relationships to maximize reimbursement while aligning with organizational goals.