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Job Title: Director of Managed Care
Location: Jupiter, FL (5 days onsite per week)
Work Authorization: USC/GC Holder
Job Type: Direct-Hire
Employment Eligibility: Gravity cannot transfer nor sponsor a work visa for this position. Applicants must be eligible to work in the U.S. for any employer directly (we are not open to contract or “corp to corp” agreements).
Position Summary
Under the direct supervision of the Chief Financial Officer, The Director of Managed Care is responsible for leading the organization’s managed care strategy, including the negotiation, implementation, and management of payer contracts. This role requires deep expertise in payer-side managed care, particularly in contract negotiations with insurance companies operating in the Florida market. The Director will collaborate with executive leadership and cross-functional teams to ensure optimal reimbursement, compliance, and strategic alignment with organizational goals.
Key Responsibilities
- Lead the development and execution of managed care strategies, including payer contract negotiations and relationship management.
- Negotiate complex agreements with insurance companies, with a strong focus on Florida-based payers.
- Evaluate and optimize managed care contracts, reimbursement rates, and performance metrics.
- Stay current with healthcare regulations, payer trends, and market dynamics to proactively adjust strategies.
- Collaborate with finance, revenue cycle, and operational teams to assess financial impact and ensure alignment.
- Manage contracting for hospitals, physicians, and ancillary providers.
- Oversee credentialing submissions and ensure timely responses to payer requests.
- Audit payments and resolve operational issues related to contract terms.
- Develop strategies for incorporating new technologies and reimbursement models into contracts.
- Lead and mentor a small team (currently one direct report), with potential to grow the department.
- Provide regular updates and strategic recommendations to executive leadership.
- Maintain confidentiality and uphold organizational policies and procedures.
Education
- Bachelor’s degree in healthcare administration, business administration, finance, or equivalent experience required.
- Master’s degree in healthcare administration, business administration, or related field preferred.
Experience & Qualifications
- Minimum of 7 years of experience in managed care and healthcare administration, with a strong focus on payer-side negotiations.
- Proven success negotiating contracts with insurance companies, especially within the Florida market.
- Strong analytical skills, including experience with financial modeling and data analysis.
- Deep understanding of healthcare regulations, compliance standards (HIPAA, CMS), and managed care finance.
- Excellent communication and interpersonal skills, with the ability to influence and collaborate across departments.
- Demonstrated leadership ability to build teams, develop talent, and foster a culture of collaboration.
- Strong project management skills and ability to oversee multiple initiatives simultaneously.