About this opportunity
PAM Health Corporate Office lists this Senior Vice President (SVP) of Managed Care | PAM Health Corporate opportunity in hampden township, Pennsylvania. Review the employer’s description below for duties, qualifications and application requirements.
Job description
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
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
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.
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
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Who can apply
Review the original listing for work authorization, qualifications and employer requirements.