Director Payer Engagement

Sca-Health-; United States; On-site; USD 150,000 - 175,000; Full time

Job summary

SCA Health, part of Optum, seeks a Director of Payer Engagement to develop regional payer strategies for ambulatory surgery centers, specialty practices, and related service lines. You will translate market dynamics and reimbursement insights into actionable plans, while leading negotiations and payer partnerships.

The role emphasizes leadership, collaboration, and driving enterprise value through innovative payment solutions and cross-functional influence within a matrixed healthcare

Qualifications

• Bachelor's degree required; Master's degree preferred.
• Minimum 7-10 years of experience in healthcare payer contracting, managed care, healthcare operations, consulting, or related field.
• Demonstrated experience negotiating commercial payer agreements and managing complex stakeholder relationships.

Responsibilities

• Develop and execute complex payer contracting and reimbursement strategies that support sustainable revenue growth, enterprise objectives, and innovative payment solutions.
• Lead negotiations and strategic initiatives that advance market growth, service line expansion, acquisitions, and value-enhancing payer partnerships.
• Build and maintain strong relationships both internally within a matrixed organization and externally with payers, in support of enterprise priorities.
• Remove barriers and foster creativity in navigating challenges for their team.
• Partner with Corporate Development and Operations to create market strategies, in alignment with payer partnerships, to identify new markets that lead to merger, de novo, and investment opportunities.
• Provide leadership, mentorship, and developmental coaching that fosters collaboration, innovation, inclusion, and high team performance.

Skills

Healthcare reimbursement

Strategic thinking

Stakeholder management

Data analysis

Communication skills

Relationship-building

Education

Bachelor's degree

Master's degree preferred

Tools

Microsoft Excel

Microsoft Office

Data analysis tools

Job description

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

Overview

The Director of Payer Engagement is responsible for developing and executing regional payer strategies that support revenue sustainability, growth, and enterprise value across a portfolio of ambulatory surgery centers, specialty practices, surgical hospitals, and related service lines. This role serves as a strategic partner to Operations, Development, Revenue Cycle, Finance, and Clinical leadership, translating market dynamics, payer opportunities, and reimbursement insights into actionable strategies.

The Director leads complex payer negotiations, advances innovative payment solutions, and drives strategic initiatives that support organizational objectives. This teammate demonstrates entrepreneurial thinking, operates with minimal supervision, and effectively influences internal and external stakeholders within a matrixed healthcare environment.

Duties & Responsibilities

• Develop and execute complex payer contracting and reimbursement strategies that support sustainable revenue growth, enterprise objectives, and innovative payment solutions.
• Lead negotiations and strategic initiatives that advance market growth, service line expansion, acquisitions, and value-enhancing payer partnerships.
• Build and maintain strong relationships both internally within a matrixed organization and externally with payers, in support of enterprise priorities.
• Remove barriers and foster creativity in navigating challenges for their team.
• Partner with Corporate Development and Operations to create market strategies, in alignment with payer partnerships, to identify new markets that lead to merger, de novo, and investment opportunities.
• Provide leadership, mentorship, and developmental coaching that fosters collaboration, innovation, inclusion, and high team performance.

Skills

• Advanced knowledge of healthcare reimbursement methodologies and commercial payer contracting.
• Ability to think strategically, identifying opportunities and risks within portfolios.
• Ability to balance competing priorities and make decisions that maximize enterprise value.
• Exceptional communication, influence, and stakeholder management skills.
• Expertise in utilizing data and translating findings into clear, actionable plans for stakeholders.
• Strong relationship-building skills with both external partners (payers) and internal collaborators, such as operational leaders and physician partners.

Qualifications

• Bachelor's degree required; Master's degree preferred.
• Minimum 7-10 years of experience in healthcare payer contracting, managed care, healthcare operations, consulting, or related field.
• Demonstrated experience negotiating commercial payer agreements and managing complex stakeholder relationships.
• Proven ability to lead strategic initiatives and influence outcomes across a matrixed organization.
• Advanced proficiency in Microsoft Office applications and data analysis tools.
• Ability to travel as needed to support payer and company meetings. (approximately 30%).

USD $150,000.00/Yr. USD $175,000.00/Yr.