Director of Payer Contracts, Ops & Credentialing

Nicklaus Children's; Miami (FL); On-site; USD 170,000 - 260,000; Full time

Job summary

Nicklaus Children's seeks a Director Payer Contract/Ops/Credentialing to lead all payer contracting and credentialing across the Health System in Miami, FL. You will guide senior leadership on pricing, negotiations, and delegated credentialing, building a strong team and ensuring regulatory compliance while adapting to a changing payer landscape.

This role requires strategic vision and hands-on leadership of a talented work force.

Qualifications

• Bachelor's Degree in Business Administration or Health Management
• 7-10 years of management experience in the finance/analytics/accounting field- healthcare related.
• 7-10 years of hospital or payer contracting and negotiating experience.

Responsibilities

• Oversee payer contracting and credentialing for the Health System.
• Collaborate with senior leadership to shape pricing and negotiations.
• Lead the Credentialing function and manage subordinates.
• Develop contracting strategies with payers and affiliates.
• Ensure compliance with legal and regulatory requirements.
• Mentor and develop team, monitor performance and training.
• Communicate payer strategy and performance to executives.
• Manage in-network and out-of-network contracting for hospital and physicians.

Skills

Leadership

Strategic thinking

Negotiation

Financial analysis

Communication

Project management

Microsoft Excel

Education

Bachelor's degree in Business Administration or Health Management

Tools

Microsoft Excel

Job description

Nicklaus Children's seeks a Director Payer Contract/Ops/Credentialing to lead all payer contracting and credentialing across the Health System in Miami, FL. You will guide senior leadership on pricing, negotiations, and delegated credentialing, building a strong team and ensuring regulatory compliance while adapting to a changing payer landscape.

This role requires strategic vision and hands-on leadership of a talented work force.