Director - Managed Care

Mount Sinai Medical Center•Miami Beach, FL

1d•Onsite

About The Position

As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers. Culture of Caring: The Sinai Way Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.

Requirements

Bachelor’s degree required; Master’s preferred.
7–10 years of managed care contracting experience within a hospital or health system.
Strong negotiation, financial analysis, and communication skills.
Experience with value‑based care models and reimbursement methodologies.

Responsibilities

Leads all day‑to‑day managed care operations, serving as the primary operational point of accountability for contracting activities, payer issue resolution, and contract performance oversight.
Executes hospital and physician contracting efforts—including negotiation of rates, terms, and contract language—based on strategic direction and priorities set by the VP and executive leadership.
Oversees and directs the financial modeling and contract performance analysis process, ensuring that all analyses support negotiation activities and reflect organizational expectations.
Ensures all aspects of the negotiation lifecycle are completed thoroughly and accurately, including data preparation, modeling, terms review, internal alignment, finalization, and implementation.
Collaborates closely with Revenue Cycle, Finance, Population Health, and other stakeholders to ensure negotiated terms are implemented correctly and that ongoing performance aligns with expected financial and operational outcomes.
Provides operational leadership, guidance, and support to Managed Care staff, ensuring daily work is aligned with department goals and Medical Center strategy.
Monitors contract performance on an ongoing basis, identifies variances, and initiates corrective actions in coordination with internal stakeholders and under VP direction.