Director of Managed Care Contracting, Managed Care

Job not on LinkedIn

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🔴 Lead

👔 Director

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Baptist Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🤝 Non-profit

Healthcare • Non-profit

Baptist Health is the region’s largest not-for-profit healthcare organization based in South Florida. It operates a system of hospitals, outpatient centers, urgent care facilities and physician practices (including 12 hospitals, more than 29,000 employees, 4,500 physicians, and roughly 200 outpatient locations, per the provided information) and is organized around nationally recognized centers of excellence in cancer, heart and vascular, brain and spine, and orthopedic care. Baptist Health is faith-based, supported by philanthropy, and emphasizes clinical quality, patient safety, workforce development, and community-focused care; it also highlights workplace awards and high rankings in national hospital and specialty evaluations.

📋 Description

• Oversee all aspects of managed care negotiations, including reimbursement rates, contract structure, language, terms, and claims settlements • Provide leadership through planning, organizing, coordinating, monitoring, and evaluating department services • Advise the Vice President of Payor Strategy on contract language and structure enhancements to reduce compliance issues and improve net revenue • Lead execution and maintenance of contract documents • Load executed contracts into contract adjudication systems • Communicate and educate appropriate parties throughout the health system about contract terms and conditions • Resolve payer payment and performance terms • Complete managed care provider credentialing • Onboard and train team members in payer strategy and negotiations • Develop a sustainable team • Support the mission and vision of Baptist Health System in a leadership capacity

🎯 Requirements

• Experience and qualifications sufficient to oversee managed care negotiations, contract reimbursement rates, structure, language, terms, claims settlements, and provider credentialing • Leadership experience in planning, organizing, coordinating, monitoring, and evaluating departmental services • Knowledge of payer strategy and negotiations • Ability to lead contract execution and maintenance and load executed contracts into contract adjudication systems • Ability to communicate and educate stakeholders on contract terms and conditions • Ability to resolve payer payment and performance terms • Ability to onboard and train team members and develop a sustainable team