Director of Managed Care Relationships, Southern California Market

About the Role

Key Responsibilities

• Build and maintain managed care payer relationships to support market strategies, ensuring appropriate contact and communication at all necessary levels within payor organizations.
• Communicate ScionHealth's value proposition and resolve barriers to entry with payers.
• Serve as a liaison between Managed Care and internal/external stakeholders, building trusted relationships.
• Manage all aspects of assigned managed care contracts and payer relationships, including clinical and operational matters.
• Sponsor and facilitate quarterly Joint Operation/Quality Meetings (JQCs) with Managed Care leadership to identify business growth opportunities and resolve challenges.
• Sponsor and facilitate monthly Key Touch Point Meetings with critical external and internal customers.
• Identify and pursue strategic business growth opportunities with key decision makers in the payer community.
• Educate and train market operations and support services on new or renegotiated contracts.
• Create tailored presentations and materials to support managed care business development.
• Conduct ongoing research to identify new managed care business opportunities.

Requirements

• Bachelor's degree in business or a related field.
• Five to seven (5-7) years of healthcare experience in managed care contracting, payer/provider relations, or business development.
• Experience supporting internal customers and collaborating with external stakeholders.
• Strong organizational and interpersonal skills, including working with Medical Directors and Senior Utilization Management teams.
• Knowledge of payer contract terminology and reimbursement methodologies.
• Effective verbal, written, and presentation communication skills in English.
• Ability to work under stress, meet deadlines, and adapt to changing objectives.
• Proficiency with applications such as Excel, PowerPoint, Word, and virtual meeting facilitation tools.
• Ability to manage multiple priorities and projects simultaneously.
• Ability to travel approximately 30% of the time.

Nice to Have

• Clinical experience in healthcare.
• Knowledge of the Post-Acute Industry.