Sr. Director, Medical Administration & Financial Management

Palm Coast, FL, USA|Onsite

Job Overview

Employment Type

Full-time

Compensation

Salary

Range $119,700.00 - $129,000.00

Benefits

Health Insurance

Dental Insurance

Paid Time Off

Retirement Plan

Professional Development

Employee assistance program

Disability insurance

Job Description

CoreCivic is a leading provider of corrections management, detention, and residential treatment services across the United States. With a commitment to public safety and community betterment, the company operates specialized facilities and offers services that support rehabilitation and operational excellence. CoreCivic focuses on integrating effective healthcare management within their facilities, ensuring the health and safety of their residents, and continuously improving service delivery through innovation and leadership. The company values employees who are committed to service, uphold high professional standards, and strive to positively impact the public good. CoreCivic provides a dynamic work environment for professionals looking to grow and make a meaningful difference.\n\nThe role of Senior Director, Medical Administration and Finance Management at CoreCivic is a critical leadership position responsible for overseeing the provider network, claims processing, and financial management within the Health Services division. This position requires hands-on involvement in managing healthcare claims, expanding provider networks, and ensuring that financial resources dedicated to non-labor medical costs are used efficiently and effectively. The Senior Director leads a team to meet rigorous operational, quality, and cost performance standards, working closely with various internal departments and external healthcare providers to support CoreCivic's facilities throughout the country.\n\nBased in Brentwood, Tennessee, this full-time position involves onsite work with potential domestic travel requirements. The Senior Director will implement strategies to streamline claims processing, manage provider agreements, and enhance healthcare service delivery with an emphasis on budget adherence and regulatory compliance. This role demands strong leadership, analytical capabilities, and expertise in healthcare financial administration. With an annual salary range between $119,700 and $129,000, the role offers a competitive compensation package for a seasoned professional dedicated to improving health services in a corrections-oriented environment. The incumbent will be instrumental in fostering collaboration between claims, provider networks, utilization management, scheduling, and offsite medical providers to ensure timely and accurate claims handling. The position also includes mentoring and developing team members, overseeing budgeting and staffing plans, and driving continuous improvement initiatives to meet key performance indicators. Knowledge of Medicare and CMS requirements, expertise in healthcare cost and clinical data analysis, and proficiency with coding systems such as HCPCS, CPT, and ICD are essential for success in this role. The Senior Director represents a pivotal figure in advancing CoreCivic's mission to deliver quality healthcare management while maintaining compliance and fiscal responsibility within a complex operational setting.

Job Requirements

Bachelor’s degree from an accredited college or university
Minimum seven years of relevant experience in healthcare claims processing, provider network development, or financial management
At least five years of supervisory experience in healthcare cost and clinical data analysis
Knowledge of Medicare and CMS regulatory requirements
Proficiency in healthcare coding systems such as HCPCS, CPT, and ICD
Ability to manage complex data analysis and reporting
Strong organizational and multitasking capabilities
Excellent communication and leadership skills
Willingness to work onsite in Brentwood, TN
Ability to travel domestically as required

Job Qualifications

Graduate from an accredited college or university with a Bachelor’s degree
Seven or more years of experience in claims processing, provider network development, or financial management within the health insurance industry or corrections-based administrative healthcare
Five years of supervisory experience in healthcare cost and clinical data analysis and with coding systems such as HCPCS, CPT, and ICD
Additional medical claims or utilization management experience may be substituted for required education on a year-for-year basis
Knowledge and understanding of Medicare and CMS requirements
Excellent analytical and decision-making skills preferred
Must be organized, attentive to detail, and able to multi-task while maintaining professionalism
Strong leadership skills including excellent interpersonal, communication, problem-solving, and negotiating skills
Proficiency in Microsoft Office applications including intermediate or advanced proficiency with Microsoft Excel

Job Duties

Oversee day-to-day claims processes, including inventory management and claims processing, claim adjustments, recoupments, and refunds to meet internal and CMS quality and timeliness standards
Oversee day-to-day provider network processes, including provider contract agreements, provider relations, and expanding access to care for medical services not delivered internally by CoreCivic medical team members, and act as an approver and signatory for provider agreements
Develop regular and ad-hoc reporting and analysis for non-labor medical costs, manage and administrate health services budgets, and assist with development and implementation of non-financial health services reporting
Build a high-functioning team that meets all operating goals, including quality, efficacy and cost of health care, administrative expense, customer service, performance improvement, regulatory requirement satisfaction, and staff engagement
Work with executive leadership to execute the mission and goals established for the Health Services team
Define direction and strategy for the Provider Network, Claims Processing, and financial management functions, identify gaps in systems, technology, budget, and processes for responsible teams
Develop, manage, and maintain staffing plans to support fluctuating resident populations and ensure performance standards are met or exceeded