Director of Managed Care

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. Department: CC019043 Managed Care Job Description Summary: The Director of Managed Care leads all day‑to‑day managed care operations, including contracting, performance oversight, and credentialing. Working under the strategic direction of the Vice President, this role manages the execution of hospital and physician contract negotiations and ensures accurate implementation of rates and terms. The Director provides operational leadership to the Managed Care team and oversees the provider credentialing staff, ensuring timely and compliant processes. This position collaborates with key departments to monitor contract performance, resolve payer issues, and support organizational financial and operational goals in alignment with Medical Center strategy. Key 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. 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. Benefits: We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs: Health benefits Life insurance Long-term disability coverage Healthcare spending accounts Retirement plan Paid time off Pet Insurance Tuition reimbursement Employee assistance program Wellness program On-site housing for select positions and more! Degree Requirements: Certification: More than 4,000 people work at Mount Sinai Medical Center at more than a dozen locations throughout sunny South Florida, including our flagship, 672-bed hospital on Biscayne Bay at the gateway to Miami Beach. We’re the largest, independent, not-for-profit hospital in South Florida, and we’re the only hospital Healthgrades recognized for four years running as one of the top 5% in the nation. Clearly, clinical excellence is at our core.