Managed Care Senior Manager - FT - Days - MHS
Memorial Healthcare SystemFlorida, United States
Posted January 20, 2026
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 manager responsible for deploying and contributing to strategic and tactical initiatives for negotiations with national and regional payors.
Requirements
- Execute, contribute and manage complex legal, financial and operational contract language negotiations in concert with the Director of Managed Care or independently as applicable to the negotiation.
- Plan and monitor activities of staff and team members including hiring, orienting, training, mentoring, continuing education, evaluating, coaching and disciplinary actions, as applicable.
- 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.
- Interface with managed care plans on claim reconciliations, trended issues and operational projects.
- Determine root cause and seek resolution.
- Evaluate payor assessments of overpayments and effectively dispute or resolve for settlement.
- Escalate, monitor and manage operational issues from Managed Care Revenue Optimization, Accounts Receivable Management or Joint Operations for solution or potential dispute resolution.
- Advise and support optimal operational performance by collaborating with other departments and facility leadership impacted by payer organizations policies for authorization, denials, discharge planning, pharmaceutical programs, etc.
- Communicate, coordinate and research to collect information to resolve issues.
- Research new business opportunities (relationships, pricing, services, structures, operations, quality).
- Respond to insurance industry activities, healthcare reform, payer strategies, emerging market demands and legislative considerations and changes to the managed care industry to maintain and competitive position.
- Monitor department operations, activities, resources to meet budget and goals.