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

PAM Health•Enola, PA

6d•Onsite

About The Position

The Senior Vice President (SVP) of Managed Care is responsible for providing strategic leadership and oversight of the organization's managed care and payor engagement strategy across a multi-state network of Inpatient Rehabilitation Facilities (IRFs), Long-Term Acute Care Hospitals (LTACHs), outpatient programs, home health agencies, physician enterprises, and behavioral health hospitals. This executive leads enterprise-wide contracting, reimbursement optimization, and payor partnerships while developing scalable managed care strategies that support organizational growth, regulatory compliance, patient access, operational performance, and financial success. The SVP collaborates closely with Executive Leadership, Operations, Finance, Revenue Cycle, Clinical Leadership, and Admissions to align managed care initiatives with the organization's strategic objectives. The SVP provides leadership to the Managed Care team, including Regional Directors of Managed Care, and is responsible for directing departmental priorities, contract negotiations, and implementation of managed care policies across the organization. This role oversees relationships with Commercial, Medicare Advantage, Managed Medicaid, ACA Exchange, Medicare ACO, TRICARE, VA Community Care Network (VA CCN), Workers' Compensation, and other governmental payors, while also leading value-based care initiatives and Supplemental Directed Payment Programs (DPP) across the organization's 17-state footprint.

Requirements

Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required.
10+ years of progressive leadership experience in managed care, payor contracting, Utilization Review, or claims or healthcare administration
Significant experience within post-acute care, hospital systems, or healthcare services as well as Professional Service contracting
Experience in working with Health Plans in network contracting role or claim services a distinct plus
Proven success in contract negotiation, payor strategy, and revenue optimization
Expertise in all forms of reimbursement such as per diems, episode pricing, capitation, O/P Fee Schedules, RBRVS for professional services
10+ years of progressive leadership experience in managed care, payor contracting, or healthcare administration
Significant experience within post-acute care, including IRF and LTAC settings strongly preferred
Experience working within multi-state healthcare organizations with an understanding of varying regulatory and reimbursement environments

Nice To Haves

Master’s degree (MBA, MHA, or similar) strongly preferred

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 managed care team, including Regional Directors, ensuring 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 ensure 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
Promotes cooperation, fairness and equity; shows respect for people and their differences; works to understand perspectives of others; demonstrates empathy; brings out the best in others and in his/her team
Coaches, evaluates, develops, and inspires staff; sets expectations; recognizes achievements
Demonstrates accountability and sound judgment in managing company resources; appropriate understanding of confidentiality and company values; adheres to and supports company policies, procedures and safety guidelines
Identifies problems and involves others in seeking solutions; conducts appropriate analysis and searches for best solutions; effectively and efficiently implements appropriate responses to correct problems; responds promptly and effectively to new challenges
Makes clear, consistent decisions; acts with integrity in all decisions; distinguishes relevant from irrelevant information; makes timely, appropriate decisions.
Understands company vision and aligns priorities accordingly; measures outcomes; uses feedback to redirect as required; evaluates alternatives; appropriately organizes complex issues to desirable resolution
Connects with peers, subordinate employees and all customers; actively listens; clearly and effectively shares information; demonstrates effective oral and written communication skills; negotiates effectively.
Strives for efficient, effective, high-quality performance in self and in the department; delivers timely and accurate results; resilient when responding to matters that are challenging; takes initiative to make improvements
Motivates others; accepts responsibility; maintains high morale in department; develops trust and credibility; expects honest and ethical behavior of self and staff
Encourages cooperation and collaboration; builds effective teams; works in partnership with others; is flexible; responsive to the needs of others
Maintains up-to-date skills through involvement with professional organizations and/or continuing education
Maintains the highest level of customer service via courtesy, compassion and positive communication.
Promotes the mission and vision of PAM Health within the work environment and the community.
Respects dignity and confidentiality by adherence to all applicable policies and procedures.
Works in a manner that promotes safety; wears clothing appropriate to the performance of the job.
Participates in OSHA required training.
Follows universal precautions as appropriate for position; complies with Employee Health requirements for continued employment.
Reports unsafe practices to management.
Knows own role in case of an emergency.