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

Overview

The Senior Vice President (SVP) of Managed Care leads enterprise-wide managed care strategy, including contracting, reimbursement optimization, and payor partnerships across PAM Health’s multi-state post-acute care platform. This role drives financial performance, supports patient access, and ensures alignment with regulatory requirements and organizational goals.

As a key executive leader, the SVP partners with operations, finance, clinical, admissions, and revenue cycle teams to integrate managed care initiatives and optimize outcomes. The role oversees a high-performing team and leads engagement across all major payor segments, including commercial, Medicare, Medicaid, and government programs.

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

II. Leadership

· Inclusiveness: 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

· Managing Staff: Coaches, evaluates, develops, and inspires staff; sets expectations; recognizes achievements

· Stewardship and Resource Management: 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

· Problem-Solving: 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

· Decision-Making: Makes clear, consistent decisions; acts with integrity in all decisions; distinguishes relevant from irrelevant information; makes timely, appropriate decisions.

· Strategic Planning and Organizing: Understands company vision and aligns priorities accordingly; measures outcomes; uses feedback to redirect as required; evaluates alternatives; appropriately organizes complex issues to desirable resolution

· Communication: Connects with peers, subordinate employees and all customers; actively listens; clearly and effectively shares information; demonstrates effective oral and written communication skills; negotiates effectively.

· Quality Improvement: 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

· Leadership: Motivates others; accepts responsibility; maintains high morale in department; develops trust and credibility; expects honest and ethical behavior of self and staff

· Teamwork: Encourages cooperation and collaboration; builds effective teams; works in partnership with others; is flexible; responsive to the needs of others

· Development: Maintains up-to-date skills through involvement with professional organizations and/or continuing education

II. Customer Service

· 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.

III. Health and Safety

· 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.

Qualifications

Education and Training: Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required. Master’s degree (MBA, MHA, or similar) strongly preferred

Experience:

• 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

Knowledge, Skills, and Abilities:

• 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