Managed Care Manager | Business Office | Nonprofit Hospital System | Southeast, US

Competitive Compensation | Comprehensive Benefits | Relocation Assistance | Career Growth Potential

In this high-profile role, the Manager, Managed Care oversees managed care contracting, denials management, and underpayment recovery to maximize reimbursement and strengthen revenue cycle performance. This leader develops contract optimization strategies, analyzes reimbursement and denial trends, collaborates with payer leadership to resolve complex payment issues, and ensures compliance with regulatory and contractual requirements. Success in this role requires expertise in hospital billing, charge structures, managed care contracting, and clinical and technical denials, along with a strong focus on operational efficiency and continuous financial improvement.

About the Community:

Located within one of the South’s most dynamic metropolitan regions, this community offers an exceptional quality of life paired with a strong economic foundation.

Consistently recognized for its affordability, livability, and business-friendly environment, the area combines Southern hospitality with modern amenities and cultural vibrancy. Residents enjoy:

• Affordable housing and a low overall cost of living
• Low tax burden and strong economic stability
• Vibrant arts, music, and entertainment scene
• Collegiate sports, with nearby universities that attract students from across the country
• Outstanding dining and cultural attractions
• Excellent educational opportunities
• Mild four-season climate and abundant outdoor recreation

Within easy driving distance are:

• White-sand Gulf Coast beaches
• Scenic lakes, rivers, and rolling countryside
• Historic towns and thriving urban centers
• Mountain landscapes and hiking destinations

For leaders seeking both professional fulfillment and an outstanding lifestyle, this location offers both.

Southeast, US

• Hospital system with a strong focus on revenue cycle performance, payer collaboration, and financial improvement
• Lead daily operations for managed care contracting, denial resolution, underpayment recovery, and payer performance activities
• Oversee teams responsible for contract support, payer denials, underpayments, appeals, and related business office functions
• Develop and implement strategies to improve managed care contract performance, reimbursement accuracy, and overall revenue outcomes
• Partner with payer representatives and internal leaders to resolve complex denial and underpayment issues
• Review denial trends, underpayment patterns, contract variances, and reimbursement concerns to identify opportunities for improvement
• Support financial analysis related to payer performance, contract terms, payment accuracy, and revenue cycle results
• Ensure timely reporting of reimbursement activity, denial trends, contract performance, and operational metrics
• Provide oversight for clinical, technical, billing, and contractual denial processes
• Collaborate with hospital billing, coding, finance, clinical, compliance, and revenue cycle teams to address payer-related concerns
• Promote compliance with payer requirements, regulatory expectations, contractual obligations, and internal policies
• Lead process improvement efforts that strengthen workflows, reduce preventable denials, improve collections, and support operational efficiency
• Provide leadership, coaching, and accountability for staff while fostering teamwork, accuracy, professionalism, and continuous improvement

• Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or a related field required, Master’s degree preferred
• Minimum of 10 years of progressive healthcare finance, revenue cycle, managed care, reimbursement, or related experience
• Minimum of 5 years of supervisory or management experience
• Strong knowledge of managed care contracting, payer negotiations, reimbursement methodologies, and contract performance monitoring
• Experience with denial management, appeals, underpayment resolution, payer follow-up, and revenue recovery processes
• Understanding of hospital billing practices, charge structures, clinical denials, technical denials, and payer requirements
• Strong analytical skills with the ability to review data, identify trends, evaluate complex issues, and recommend effective solutions
• Proficiency with Microsoft Office, reporting tools, patient accounting systems, and related business office technology
• Ability to manage multiple priorities, meet deadlines, and remain professional in challenging situations
• Strong leadership, communication, organization, interpersonal, and customer relations skills
• Ability to work both independently and collaboratively with internal teams, leadership, payers, and external partners

Galileo Search, LLC partners with hospitals and healthcare organizations across the United States to identify, recruit, and retain the industry's most accomplished professionals and executives. Our clients include community and critical access hospitals, health systems, academic medical centers, and Fortune 500 corporations. To learn more about Galileo Search, LLC, visit our website at www.galileosearch.com

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