Director - Managed Care - FT Days - MHS
Memorial Healthcare SystemFlorida, United States
Posted July 22, 2025
Full Time
About the Company
Be at the heart of exceptional care. Team MHS Florida is an award-winning group of friends and colleagues at one of the largest not-for-profit health systems in the nation. We're 17,000 strong, advancing towards a brighter future together. We're passionate about the work we do, delivering deep, personalized care for patients and their families. That’s what we call the Memorial Experience. Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity. Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law. We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program. Employment is subject to post offer, pre-placement assessment, including drug testing.
Job Description
Corporate-level leader responsible for executing enterprise-wide strategic and tactical initiatives for complex negotiations with major national and regional payors.
Requirements
- Enhance, estimate and preserve net revenues.
- Assure financial viability of contracts through financial analysis and forecasting in conjunction with Financial Analyst(s), contract negotiations and issue resolution.
- Execute strategies and guides operations to protect and build market share.
- Plan and monitor activities of staff and/or team members including hiring, orienting, training, mentoring, continuing education, evaluating, coaching & disciplinary actions, as applicable.
- Execute and manage complex legal, financial and operational contract language negotiations.
- Direct and analyze financial performance, reports and models, quality metrics and cost savings for negotiations with major national and regional payors.
- Monitor department operations, activities, resources to meet budget and goals.
- Respond to insurance industry activities, healthcare reform, payer strategies, emerging market demands, and legislative considerations and changes to the managed care industry to maintain a competitive position.
- Initiate and research new business opportunities (relationships, pricing, services, structures, operations, quality).
- Escalate, monitor and manage operational issues from Managed Care Revenue Optimization, Accounts Receivable Management or Joint Operations for solution or potential litigation.
- Advise and support optimal operational performance by collaborating with other departments and facility leadership impacted by payer organizations polices for authorization, denials, discharge planning, pharmaceutical programs, etc.
- Communicate, coordinate and research to collect information to resolve issues.
Benefits
- Generous Paid Time Off
- 401k Matching
- Retirement Plan
- Visa Sponsorship
- Four Day Work Week
- Generous Parental Leave
- Tuition Reimbursement
- Relocation Assistance