Payer Engagement Manager

Surgical Care Affiliates Pasadena, CA

About the Job

Surgical Care Affiliates (SCA) is transforming specialty care in our communities. We relentlessly create value by aligning physicians, health plans and health systems around a common goal: delivering exceptional care and healing to our patients and communities we serve. We are driven to achieve the quadruple aim in health care: high quality outcomes and a better experience for patients and providers, all at a lower total cost of care. As a national leader in surgical care, SCA’s 10,000 teammates operate more than 250 surgical facilities that serve nearly 1 million patients per year. For more information on SCA, visit www.scasurgery.com.

 

Why join SCA? Consider the following fantastic benefits…

 

  • Positive work culture
  • Career growth opportunities
  • Comprehensive medical, vision and dental insurance – eligible on Day 1 of employment
  • Paid time off plus 8 paid holidays
  • Maternity/paternity/adoption benefits
  • Employer-paid life and short- and long-term disability insurance
  • Excellent 401(k) Plan

  • Support Managed Care Rate Growth:  Teammate will be responsible for all aspects of managed care contracting for a defined portfolio of facilities.  The teammate will partner with the Sr. Director of Managed Care to provide strategic direction to the Operations team around reimbursement, fee schedule management, and growth of ASCs.  In addition, they will proactively pursue innovative payment strategies for the top payors within the defined portfolio.   
  • Develop Differentiated Payer Relationships:  Teammate will become viewed by payers as a problem solver who they want to call.  The teammate will require a natural presence as a leader who is able to actively read an audience and make the complex sale not just of the value proposition of ASCs but of innovative payment methodologies that require the payer to try something new.
  • Enable Strategic Acquisitions: Teammate will partner with Development and Operations team to identify suitable growth opportunities and lead rate analysis to ensure clear understanding of contracting impact (rate changes and timing) on pro-formas.
  • Enable Organizational Alignment to Grow Revenue:  The teammate will actively take ownership for overall rate growth through an active communication strategy that will typically include participation in monthly operating reviews, presentations to physician partners, engaging Sales to develop physician recruiting plans, partnering with Revenue Cycle to resolve contractual issues impacting collections, etc.
  • Accurate, timely and actionable growth metrics and reporting:  Teammate will deliver metrics / reporting package to SCA’s Operations and Finance Teams to ensure teammates responsible for revenue and volume growth are clear about the trends and opportunities to increase profitable case volume.

  • Bachelors degree or at minimum 3 years of direct experience required
  • 1+ years health plan contracting/healthcare operational/revenue cycle preferred
  • Healthcare experience with contracting or closely related area, revenue cycle and/or denial management experience preferred
  • Travel to health plan meetings, company meetings, center visits, etc. (20%)
  • Experience in a contracting role preferred – health plan, provider, or ancillary contracting - or equivalent health care facility operations experience. ASC operations experience a plus.
  • Qualified individuals will possess the following success behaviors and demonstrate the ability to leverage them for successful outcomes across all aspects of the work they perform:
    • collaborative, creative, disciplined, driven and influential
  • Understanding of the California managed care environment preferred.
  • Ability to monitor and communicate trends in national, regional, and local markets.
  • Ability to leverage data and execute on defined action plans - Experience with Excel required.
  • Strong verbal and written communication skills, as well as the ability to establish relationships and network within the industry.