Director of Managed Care

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

Experience & Qualifications