Senior Vice President (SVP) of Managed Care | PAM Health Corporate

PAM Health•Enola, PA

About The Position

The Senior Vice President (SVP) of Managed Care provides strategic leadership and oversight of managed care and payor engagement across PAM Health’s multi-state network of inpatient rehabilitation facilities, long-term acute care hospitals, outpatient programs, home health agencies, physician enterprises, and behavioral health hospitals. The role leads enterprise-wide contracting, reimbursement optimization, payor partnerships, and value-based care initiatives, including Supplemental Directed Payment Programs, across the organization’s 17-state footprint. The SVP develops scalable managed care strategies that support organizational growth, regulatory compliance, patient access, operational performance, and financial success. The position oversees relationships with commercial, Medicare Advantage, Managed Medicaid, ACA Exchange, Medicare ACO, TRICARE, VA Community Care Network, Workers’ Compensation, and other governmental payors. It directs the Managed Care team, including Regional Directors of Managed Care, and works closely with Executive Leadership, Operations, Finance, Revenue Cycle, Clinical Leadership, and Admissions. The position reports directly to the Senior Executive Vice President, Chief Government Relations Officer & Senior Executive Advisor. PAM Health provides specialty healthcare services through more than 80 locations, wound clinics, and outpatient physical therapy locations in 17 states. Its mission is to provide compassionate, expert care and support recovery through education and research. The company describes a collaborative work environment and offers competitive pay, paid benefit time, insurance options, and opportunities for professional growth through its Education Advancement Program.

Requirements

Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field.
At least 10 years of progressive leadership experience in managed care, payor contracting, Utilization Review, claims, or healthcare administration.
Significant experience within post-acute care, hospital systems, or healthcare services, as well as Professional Service contracting.
Proven success in contract negotiation, payor strategy, and revenue optimization.
Expertise in reimbursement models, including per diems, episode pricing, capitation, outpatient fee schedules, and RBRVS for professional services.
Experience working with health plans in a network contracting role or claim services is a distinct plus.
Ability to work within multi-state healthcare organizations and understand differing regulatory and reimbursement environments.
Demonstrated leadership abilities, including staff development, strategic planning, decision-making, problem-solving, communication, teamwork, and resource stewardship.

Nice To Haves

Master’s degree (MBA, MHA, or similar).
Significant post-acute care experience, including IRF and LTAC settings.
Experience working with health plans in a network contracting role or claim services.

Responsibilities

Lead enterprise managed care contracting strategy, including negotiation, rate optimization, and payor relationship management across commercial, government, and value-based programs.
Oversee development, review, and execution of managed care agreements, ensuring alignment with organizational, financial, and regulatory objectives.
Collaborate with operations, finance, admissions, and revenue cycle teams to improve reimbursement, reduce denials, and optimize payor performance.
Provide strategic direction and leadership to the managed care team, including Regional Directors, and ensure effective execution of priorities and initiatives.
Build and maintain relationships with national, regional, and local payors to expand market access and strengthen partnerships.
Identify opportunities for growth, contract expansion, and revenue improvement across new and existing markets and service lines.
Partner with executive leadership to assess risks, trends, and opportunities in managed care and reimbursement environments.
Monitor industry changes, CMS regulations, and payor policies to support compliance and informed strategic decision-making.
Support financial performance through contract analysis, reimbursement strategies, and collaboration on revenue cycle initiatives.
Ensure compliance with regulatory requirements and managed care contracts.
Monitor CMS, healthcare laws, and reimbursement changes.
Oversee adherence to contract terms across multi-state operations.
Partner with Legal, Compliance, and Revenue Cycle to mitigate risk.
Coach, evaluate, develop, and inspire staff; set expectations and recognize achievements.
Manage company resources responsibly and adhere to company policies, procedures, confidentiality expectations, and safety guidelines.
Promote inclusive, ethical, collaborative, customer-focused leadership and effective communication.
Participate in continuing education and/or professional organizations to maintain up-to-date skills.
Promote PAM Health’s mission and vision, maintain customer service, protect dignity and confidentiality, and follow applicable health and safety practices.