Jupiter Medical Center
Director of Managed Care
Jupiter Medical Center is the leading destination for world‑class health care in Palm Beach County and the greater Treasure Coast. Outstanding physicians, state‑of‑the‑art facilities, and innovative techniques enable the hospital to meet a broad range of patient needs. Jupiter Medical Center is the only hospital in Palm Beach, Martin, St. Lucie, and Indian River counties to receive a 4‑star quality and safety rating from CMS.
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 and Qualifications
Minimum of seven years’ experience in managed care and healthcare administration, working with third‑party payers and managed care organizations.
Keen negotiating skills and contract management skills.
Experience with data analysis and financial modeling.
Excellent analytical and problem‑solving abilities, including the ability to interpret complex data and drive data‑driven decisions.
Knowledge of hospital and managed care finance, as well as healthcare regulations and compliance standards, including HIPAA and CMS guidelines.
Excellent communication and interpersonal skills with the ability to collaborate with stakeholders internally and externally.
Strong written and verbal communication skills and experience with formal presentations.
Team player with proven ability to develop relationships with stakeholders at all levels of the organization.
Leadership ability to build teams, develop talent, and foster a culture of collaboration.
Excellent project management skills and demonstrated ability to prioritize and oversee multiple initiatives.
Ability to maintain confidential and proprietary information.
Position Summary The Director of Managed Care strategically leads the team responsible for negotiating payer agreements on behalf of Jupiter Medical Center. The Director participates in the development, negotiation, implementation, monitoring, and management of all third‑party payer contracts. The role develops and maintains relationships with payers, executives, and operational leaders across revenue cycle and finance.
Key Responsibilities
Develop and implement strategies, objectives, and tactics to achieve the organization’s strategic goals.
Collaborate with cross‑functional teams to negotiate contracts and analyze provider networks ensuring optimal value and quality.
Strategically assess contract relationships and determine appropriate changes based on local market dynamics.
Evaluate managed care contracts, performance, and reimbursement rates to identify areas for improvement.
Stay abreast of healthcare regulations and industry trends to recommend proactive adjustments.
Oversee development and maintenance of provider relationships, fostering open communication and collaboration.
Lead and mentor a managed care team, providing guidance, coaching, and support to develop a team rooted in excellence.
Analyze data and financial metrics to identify opportunities for cost savings and process improvements.
Interface with executive leadership to provide regular updates, reports, and recommendations related to managed care strategies.
Collect, organize, and submit credentialing requests in a timely manner.
Manage contracting for hospitals, physicians, and ancillary providers.
Assist in auditing payments collaboratively with other departments to resolve operational issues related to contract language.
Prepare, analyze, review, and project the financial impact of provider contracts and alternate terms.
Develop strategies to incorporate delivery and reimbursement for new technologies into existing and future contracts.
Understand and enforce all hospital and personnel policies and procedures.
Perform other duties as assigned.
Physical Requirements Requires sitting for long periods of time, stooping, bending, standing, and stretching. May require lifting up to 20 lbs. Must have manual dexterity for typing and computer data entry. Able work under a stressful environment, work independently, make sound decisions, be detail oriented, alert, and self‑motivated. Ability to push or pull up to 40 lbs, carry and lift up to 20 lbs.
Threshold Requirements
These threshold requirements are required and completed yearly.
Annual Joint Commission mandatory education requirements, in‑service and health requirements including attendance at new employee orientation.
TB/PPD Surveillance Program.
Maintenance of required professional licensing and/or certification(s).
#J-18808-Ljbffr
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 and Qualifications
Minimum of seven years’ experience in managed care and healthcare administration, working with third‑party payers and managed care organizations.
Keen negotiating skills and contract management skills.
Experience with data analysis and financial modeling.
Excellent analytical and problem‑solving abilities, including the ability to interpret complex data and drive data‑driven decisions.
Knowledge of hospital and managed care finance, as well as healthcare regulations and compliance standards, including HIPAA and CMS guidelines.
Excellent communication and interpersonal skills with the ability to collaborate with stakeholders internally and externally.
Strong written and verbal communication skills and experience with formal presentations.
Team player with proven ability to develop relationships with stakeholders at all levels of the organization.
Leadership ability to build teams, develop talent, and foster a culture of collaboration.
Excellent project management skills and demonstrated ability to prioritize and oversee multiple initiatives.
Ability to maintain confidential and proprietary information.
Position Summary The Director of Managed Care strategically leads the team responsible for negotiating payer agreements on behalf of Jupiter Medical Center. The Director participates in the development, negotiation, implementation, monitoring, and management of all third‑party payer contracts. The role develops and maintains relationships with payers, executives, and operational leaders across revenue cycle and finance.
Key Responsibilities
Develop and implement strategies, objectives, and tactics to achieve the organization’s strategic goals.
Collaborate with cross‑functional teams to negotiate contracts and analyze provider networks ensuring optimal value and quality.
Strategically assess contract relationships and determine appropriate changes based on local market dynamics.
Evaluate managed care contracts, performance, and reimbursement rates to identify areas for improvement.
Stay abreast of healthcare regulations and industry trends to recommend proactive adjustments.
Oversee development and maintenance of provider relationships, fostering open communication and collaboration.
Lead and mentor a managed care team, providing guidance, coaching, and support to develop a team rooted in excellence.
Analyze data and financial metrics to identify opportunities for cost savings and process improvements.
Interface with executive leadership to provide regular updates, reports, and recommendations related to managed care strategies.
Collect, organize, and submit credentialing requests in a timely manner.
Manage contracting for hospitals, physicians, and ancillary providers.
Assist in auditing payments collaboratively with other departments to resolve operational issues related to contract language.
Prepare, analyze, review, and project the financial impact of provider contracts and alternate terms.
Develop strategies to incorporate delivery and reimbursement for new technologies into existing and future contracts.
Understand and enforce all hospital and personnel policies and procedures.
Perform other duties as assigned.
Physical Requirements Requires sitting for long periods of time, stooping, bending, standing, and stretching. May require lifting up to 20 lbs. Must have manual dexterity for typing and computer data entry. Able work under a stressful environment, work independently, make sound decisions, be detail oriented, alert, and self‑motivated. Ability to push or pull up to 40 lbs, carry and lift up to 20 lbs.
Threshold Requirements
These threshold requirements are required and completed yearly.
Annual Joint Commission mandatory education requirements, in‑service and health requirements including attendance at new employee orientation.
TB/PPD Surveillance Program.
Maintenance of required professional licensing and/or certification(s).
#J-18808-Ljbffr