SCA, a leader in the outpatient surgery industry, strategically partners with health plans, medical groups and health systems across the country to develop and optimize surgical facilities. SCA operates more than 200 surgical facilities, including ambulatory surgery centers and surgical hospitals, in partnership with approximately 3,000 physicians.
Accountabilities / Responsibilities
The Senior Contracts Manager will enable SCA to achieve earnings growth by partnering with operations leaders to set and execute a strategy that evolves payer contracting into value-based agreements that drive targeted volume growth initiatives and strategic acquisitions.
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 payers 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.
- 3+ years payer contracting/reimbursement experience
- Bachelor's degree in business, finance, management, health management or similar field required
- Healthcare and ASC operations experience a plus
- Knowledge and experience with payer contracting and payment systems
- Travel to health plan meetings, company meetings, center visits, etc. (30%)
- Strong verbal and written communication skills as it relates to managing a managed care contractportfolio
- Ability to think strategically about markets and identify opportunities and risks within portfolio
- Ability to heavily leverage data but also translate into understandable action plans for field operations and payer engagement