Principal, Managed Care Negotiations

Fulcrum Health Partners | 100% Remote (U.S.) | Full-Time | Reports to Director, Managed Care

Fulcrum Health Partners is a healthcare advisory firm working at the intersection of provider reimbursement, payer contracting, and healthcare M&A. We represent hospitals, health systems, physician groups, and specialty providers across every state and every corner of the care continuum - sitting on their side of the table to secure the rate improvements and contract terms that protect their financial future.

The Principal, Managed Care Negotiations owns the negotiation. This is a senior individual-contributor role for a proven payer-contracting operator who can step into a client account, build the strategy, and personally drive agreements to signature across commercial, Medicare Advantage, and Medicaid managed care lines.

You’ll lead client accounts spanning the full spectrum of healthcare - from large health systems to independent specialty groups - and manage a high-volume portfolio, typically 100 to 150+ concurrent negotiations across multiple specialties, payers, and states. You’ll set rate strategy, work with finance to model financial impact, draft and counter proposals, and take contracts from analysis through execution. The work is hands-on and end-to-end: this is the person who does the negotiating, not the person who assigns it.

You’ll report to the Director, Managed Care with a high degree of autonomy.

• Serve as lead negotiator and account owner for a portfolio of provider clients, managing 50-100+ concurrent payer negotiations across commercial, Medicare Advantage, and Medicaid managed care
• Build rate strategy and negotiation roadmaps grounded in reimbursement analysis, market benchmarks, and each client’s financial objectives
• Draft, present, and counter contract proposals directly with payers, driving agreements from initial outreach through executed contract
• Model the financial impact of proposed terms and rate structures, and translate the analysis into a clear recommendation for clients
• Manage the full negotiation lifecycle across multiple specialties, provider types, and states simultaneously
• Act as the senior client contact, communicating strategy, progress, and outcomes to provider leadership
• Partner with the Director, Managed Care and internal analytics teams to sharpen strategy across the book

• 3-5 years of direct, hands-on experience negotiating managed care agreements for hospitals, health systems, physician or specialty provider groups
• Experience gained INSIDE a large payer, provider, or hospital/health-system organization in a managed care, payer-contracting, or provider-contracting role - this is a hard requirement (revenue cycle management and other adjacent functions do not qualify)
• Demonstrated command of commercial, Medicare Advantage, and Medicaid managed care contracting
• A track record of carrying multiple concurrent negotiations across different specialties, provider types, and states
• Strong reimbursement and financial-modeling fluency - fee schedules, rate methodologies, and contract-language nuance
• Sharp negotiation instincts, executive-level communication, and the judgment to own a client relationship independently
• Comfort in a fully remote, high-volume, deadline-driven environment

Candidates whose contracting exposure comes only from revenue cycle management (RCM), billing, coding, credentialing, or other adjacent functions will not be considered. This role requires direct managed care / payer / provider contract NEGOTIATION experience earned inside a large payer, provider, or hospital group.

100% remote within the United States. Full-time. Reports to the Director, Managed Care. Salary range $100,000–$130,000, commensurate with experience.

Fulcrum Health Partners is an equal opportunity employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, protected veteran status, or any other protected characteristic.