Payer Engagement Manager

Surgical Care Affiliates Deerfield, IL

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

 

SCA’s Catalyst Team supports the enterprise mission and vision while contributing to market / physician alignment strategies alongside Operations, Finance, Development and Business Development.  The Catalyst Team is comprised of dynamic individuals who support and lead strategic initiatives by better aligning with health plans, medical groups and health systems that seek to achieve the triple aim, and by developing better tools to help independent physicians – our primary customers – to succeed in the years to come.

 


SCA is currently accepting applications for a Manager position on its fast paced and innovative Catalyst team.  The Manager of Payer Engagement will partner with operations leaders to establish and execute payer contracting strategies that grow value-based initiatives and support overall SCA earnings growth.  This position will enable SCA to achieve earnings growth by partnering with senior managed care leaders who set and execute a strategy that combines payer contracting efforts with case mix, targeted volume growth initiatives, and strategic acquisitions.

 

Responsibilities:

  • 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.

Accountabilities:

 

  • Driven - self-motivated with an extraordinary will to create value, executes, achieves strong results, takes full accountability
    • Executes on cross-functional projects with appropriate supervision
    • Relentlessly pursues quantitative performance targets such as contracting plan
    • Finds challenging work rewarding and has a strong sense of urgency to solve problems and get work done
  • Collaborative - knows when to engage internal and external resources to achieve results, does so respectfully and productively, leveraging SCA's capabilities
    • Presents ideas confidently
    • Recognizes and promotes the strength of the team > individual contribution
    • Incorporates input from others into decisions and implementation
    • Finds opportunities to recognize others' good work
  • Essentialist - clear on how we create value for customers and partners, drives "vital few", keeps things simple
    • Prioritizes workload
    • Appreciates the importance of growth for SCA and our partners
  • Creative - innovative thinker; develops innovative solutions and creates new opportunities for SCA
    • Participates in creation of innovative solutions based on market opportunity through brain
    • storming and identifying opportunities for improvement
  • Influential – thought leader with clear vision, develops strong leaders & teams, persuasive internally & externally
    • Plays multiple roles in meetings including active participant and project manager
    • Forms strong cross-functional relationships throughout Catalyst and Group

Qualifications:

 

  • 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.

  Requirements: 

  • 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%)