Associate Director Payer Engagement

Overview

At SCA Health, we believe health care is about people – the patients we serve, the physicians we support and the teammates who push us forward. Behind every successful facility, procedure or innovation is a team of 15,000+ professionals working together, learning from each other and living out the mission, vision and values that define our organization. 

As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without compromising quality or autonomy.  

What sets SCA Health apart isn’t just what we do, it’s how we do it. Each decision we make is rooted in seven core values: 

• Clinical quality 
• Integrity 
• Service excellence 
• Teamwork 
• Accountability 
• Continuous improvement 
• Inclusion 

Our values aren’t empty words – they inform our attitudes, actions and culture. At SCA Health, your work directly impacts patients, physicians and communities. Here, you’ll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America.    

At SCA Health, we offer a comprehensive benefits package to support your health, well-being, and financial future. Our offerings include medical, dental, and vision coverage, 401k plan with company match, paid time off, life and disability insurance, and more. Please visit, https://careers.sca.health/why-sca, to learn more about our benefits.

Your ideas should inspire change. If you join our team, they will. 

Responsibilities

Role Description:

SCA is currently accepting applications for an Associate Director position on its fast paced and innovative Catalyst team.  The Associate Director is responsible for advancing payer relationship to support growth across a multi-state and multi-facility portfolio. This position will help to advance strategic priorities and support a variety of stakeholders responsible for contract negotiations, business development, finance, and operations through the quantitative analysis and strategic application of all payer contracts and the implications they have on financial results and growth. 

Responsibilities:

• Develop Differentiated Payer Relationships: Teammate will be viewed by payers as a problem solver who they want to call, growing and advancing payer relationships and identifying opportunities to align on strategic initiatives.  The teammate will solve complex problems and develop ways to partner with payers on innovative payment solutions that advances the growth of their portfolio.
• Enable Strategic Acquisitions: Teammate will partner with Development and Operations team to identify suitable growth opportunities and lead complex rate analysis to ensure clear understanding of contracting impact on pro-formas. This teammate will be able to interpret analyses, apply payer knowledge, and identify innovative payer initiatives to  support recommendations.
• Enable Organizational Alignment to Grow Revenue:  The teammate will have ownership for overall rate growth through an active communication strategy that will typically include participation in cross-functional project implementation, 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.  Teammate will be responsible for developing and executing contracting strategies for a defined portfolio of facilities and geographies.  The teammate anticipates facility partnership needs and proactively develop solutions to meet them by providing strategic direction to the Operations team around reimbursement, fee schedule management, and growth of ASC. Teammate will influence leaders to adopt new ideas, products, and/or approaches. 
• Accurate, timely and actionable growth metrics and reporting:  Teammate will develop and 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 profitability.  This includes reviewing and providing recommendations on work products and developing explanations on complex issues.
• Demonstrates Success Behaviors:
  • Driven - self-motivated with an extraordinary will to create value, executes, achieves strong results, takes full accountability. This teammate identifies opportunities and executes multiple projects with some supervision and identifies strategic opportunities with minimal supervisory support.
  • Collaborative - knows when to engage internal and external resources to achieve results, does so respectfully and productively, leveraging SCA's capabilities. This teammate moves from tactical execution to being recognized as a leader across teams and sought out as a subject matter expert.
  • Essentialist - clear on how SCA creates value for customers and partners, drives "vital few", keeps things simple, prioritizes workload. This teammate balances goals with tactical priorities to bring others along.
  • Creative - innovative thinker; develops innovative solutions and creates new opportunities for SCA, leads work sessions on smaller projects, identifies opportunities to think differently. This teammate initiates work sessions and predicts emerging customer needs.
  • Influential – thought leader with clear vision, persuasive internally & externally, motivates and inspires other teammates. This teammate leads discussions to influence leaders to adopt new ideas, products, and/or approaches.

Qualifications

• Bachelor’s degree and at minimum 8 years of direct experience
• 3+ years health plan contracting/healthcare operational/revenue cycle
• Experience in a payer contracting role – health plan, provider, or ancillary contracting - or equivalent health care facility operations experience.
• Experience in commercial payer strategies, pricing, and reimbursement
• 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
• Ability to heavily leverage data and execute on defined action plans
• Strong verbal and written communication skills, as well as a collaborator and skilled cross-functional communicator
• Travel to health plan meetings, company meetings, center visits, etc. (20%)

USD $110,000.00/Yr. USD $140,000.00/Yr.