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

PAM Health Corporate Office•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, and payor partnerships, developing scalable strategies that support organizational growth, regulatory compliance, patient access, operational performance, and financial success. The SVP works closely with Executive Leadership, Operations, Finance, Revenue Cycle, Clinical Leadership, and Admissions to align managed care initiatives with organizational objectives. The SVP leads the Managed Care team, including Regional Directors of Managed Care, and directs departmental priorities, contract negotiations, and implementation of managed care policies. The role oversees relationships with commercial, Medicare Advantage, Managed Medicaid, ACA Exchange, Medicare ACO, TRICARE, VA Community Care Network, Workers’ Compensation, and other governmental payors. It also leads value-based care initiatives and Supplemental Directed Payment Programs across the organization’s 17-state footprint. The position reports directly to the Senior Executive Vice President, Chief Government Relations Officer & Senior Executive Advisor. The role includes leadership, customer service, and health and safety responsibilities. The SVP is expected to promote cooperation, fairness, ethical conduct, sound resource management, effective communication, quality improvement, teamwork, and staff development; provide courteous and compassionate service; support PAM Health’s mission and vision; protect dignity and confidentiality; participate in required OSHA training; follow applicable safety practices; and report unsafe practices.

Requirements

Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field.
10 or more 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, including 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 within multi-state healthcare organizations and understanding varying regulatory and reimbursement environments.
Ability to lead and develop staff, manage resources, make decisions, solve problems, plan strategically, communicate effectively, and collaborate across teams.
Ability to maintain confidentiality and comply with company policies, procedures, and safety guidelines.

Nice To Haves

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

Responsibilities

Lead enterprise managed care contracting strategy, including negotiations, rate optimization, and payor relationship management across commercial, government, and value-based programs.
Oversee the development, review, and execution of managed care agreements, aligning them with organizational, financial, and regulatory objectives.
Collaborate with Operations, Finance, Admissions, and Revenue Cycle to improve reimbursement, reduce denials, and optimize payor performance.
Provide strategic direction to the Managed Care team, including Regional Directors, and ensure effective execution of departmental 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 markets and service lines.
Partner with executive leadership to assess risks, trends, and opportunities in managed care and reimbursement.
Monitor industry changes, CMS regulations, healthcare laws, and payor policies to support compliance and informed 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, including 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.
Promote cooperation, fairness, equity, effective communication, teamwork, and quality improvement.
Promote PAM Health’s mission and vision, provide courteous and compassionate customer service, and protect dignity and confidentiality.
Follow applicable health and safety practices, participate in OSHA-required training, and report unsafe practices.