Vice-President of Managed Care and Payer Relations

The Vice-President of Managed Care and Payer Relations is responsible for leading all aspects of payer strategy, contract negotiations and implementation, and reimbursement management to ensure sustainable growth and financial stability across the company's nursing home facilities. Develop and maintain relationships with managed care organizations, Medicare Advantage plans, commercial insurers, and accountable care networks while optimizing contract performance and expanding market access .

Join us with an attractive benefits offering:

• Competitive pay
• Medical, dental, and vision insurance
• 401K with matching funds
• Life Insurance
• Employee discounts
• Tuition Reimbursement
• Student Loan Reimbursement

Responsibilities:

Managed Care Strategy & Contracting

• Lead payer contracting and negotiations with managed care organizations, Medicare Advantage plans, and other third-party payers.
• Develop strategies to secure favorable reimbursement terms, improve rates, and expand participation in payer networks.
• Collaborate with Finance and Operations teams to analyze reimbursement models and forecast revenue impacts.
• Monitor contract compliance, payment accuracy, and payer performance; resolve underpayments and disputes.
• Evaluate new payer programs, bundled payment models, and value-based care initiatives for business opportunities.

Payer Relations & Market Development

• Build and maintain strong relationships with payer executives, provider networks, and healthcare partners.
• Serve as the primary liaison between the organization and payer representatives.
• Represent the company in industry forums, associations, and payer advisory groups to influence policy and network positioning.
• Partner with business development and admissions teams to align payer contracts with census growth strategies.

Leadership & Collaboration

• Provide strategic guidance to executive leadership on payer trends, reimbursement risks, and emerging market opportunities.
• Collaborate with clinical and operational leaders to ensure contract terms align with quality initiatives and regulatory compliance.
• Develop and deliver reports and dashboards to track payer mix, revenue performance, and contract outcomes.
• Develop contract summaries to be used by the facility leadership and accounts receivable staff at every level
• Provide education to facility leadership, marketing and admissions staff, and accounts receivable staff on the reimbursement Matrix of each contract

Requirements:

• Bachelor's degree in healthcare administration, business, finance, or related field (Master's preferred).
• 10+ years of progressive experience in managed care contracting, payer relations, or healthcare finance, with at least 5 years in a leadership role.
• Deep knowledge of payer contracting, reimbursement methodologies, and healthcare regulations.
• Experience in post-acute care, skilled nursing, or long-term care strongly preferred.
• Proven track record of negotiating complex contracts and achieving favorable terms.
• Strong financial acumen with ability to model and analyze reimbursement impacts.
• Ability to travel regularly to meet with payers, partners, and facility leadership.
• Ciena Healthcare

We are a national organization of skilled nursing, subacute, rehabilitative, and assisted living providers dedicated to achieving the highest standards of care in five states including Michigan, Ohio, Virginia, North Carolina, and Indiana.

We serve our residents with compassion, concern, and excellence, believing that every one of them is a unique person who deserves our best each day that we care for them. Join us, if you have a passion for improving the lives of those around you and working with others who feel the same way.

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