Vice President of Managed Care | PAM Health Corporate

PAM Health Corporate Office•Enola, PA

About The Position

The Vice President (VP) of Managed Care is responsible for the strategic leadership, development, and execution of all managed care and payor engagement initiatives across a multi-state platform of Inpatient Rehabilitation Facilities (IRFs) and Long-Term Acute Care Hospitals (LTACHs). This role leads enterprise-wide contracting strategy, reimbursement optimization, and payor partnerships to drive sustainable growth, operational performance, and financial outcomes across diverse post-acute care markets. The VP establishes a scalable, market-responsive managed care framework that accounts for state-specific regulatory requirements, reimbursement methodologies, and evolving payor dynamics, ensuring alignment with organizational objectives and compliance standards. As a key member of the leadership team, the VP partners closely with Operations, Finance, Clinical Leadership, and Revenue Cycle to integrate managed care strategies that support patient access, appropriate utilization, and margin optimization across all regions.

Requirements

Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required.
10+ years of progressive leadership experience in managed care, payor contracting, or healthcare administration
Significant experience within post-acute care, hospital systems, or healthcare services
Proven success in contract negotiation, payor strategy, and revenue optimization
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

Oversee negotiation, execution, and management of all managed care contracts (commercial, Medicare Advantage, Medicaid, and other payors)
Establish and maintain strong relationships with national, regional, and local payors
Ensure favorable contract terms, reimbursement rates, and performance metrics
Drive reimbursement strategies that improve revenue and margin performance
Partner with finance and revenue cycle to monitor contract performance, denials, and payment trends
Identify opportunities for rate improvement and contract renegotiation
Collaborate with operations and clinical leadership to align managed care initiatives with care delivery models
Support admissions and case management teams in navigating payor requirements and authorizations
Ensure alignment between payor expectations and operational workflows
Ensures compliance with all federal, state, and local regulatory requirements related to managed care contracting, reimbursement, and billing across IRF, LTAC, and other post-acute care settings
Monitors and interprets changes in CMS regulations, healthcare laws, and reimbursement policies impacting IRF, LTAC, and post-acute services, ensuring timely organizational alignment
Oversees compliance with payor contract terms and regulatory standards across multi-state operations, including varying state-specific licensing, reimbursement, and utilization requirements
Partners with Legal, Compliance, and Revenue Cycle leadership to proactively mitigate risk, ensure audit readiness, and address regulatory or payor-related issues
Lead, mentor, and develop managed care and payor relations teams
Foster a collaborative, high-performance culture focused on accountability and results
Provide oversight of regional and corporate managed care functions
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.