Payor Strategy Manager

Job Requirements Do you have managed care contracting, payor strategy, and healthcare financial analytics experience?Join a mission-driven healthcare team making a real impact as our next Manager of Payor Strategy and Relations.Location: Spartanburg, SCABOUT SPARTANBURG REGIONAL HEALTHCARE SYSTEMSpartanburg Regional Healthcare System is a nationally recognized, community-centered health system that has served Upstate South Carolina for more than 100 years. We provide exceptional care through our hospitals, physician practices, and specialty services. Our Payor Strategy and Relations team supports this mission by strengthening payor partnerships, advancing managed care strategy, supporting reimbursement performance, and helping leaders make informed operational and financial decisions.POSITION SUMMARYThe Manager of Payor Strategy and Relations leads the operational execution of managed care contract support, payor strategy initiatives, and financial analytics for Spartanburg Regional Healthcare System. This role manages day-to-day priorities for the Payor Strategy and Relations team, coordinates cross-functional work with Finance, Revenue Cycle, division leaders, and payor operational leaders, and ensures contract-related deliverables are completed accurately, timely, and in alignment with SRHS strategic objectives.MINIMUM REQUIREMENTSEducationBachelor’s degree required, with major in Finance, Accounting, Business, Healthcare Administration, or related field preferred.ExperienceThree or more years of experience in hospital or health plan managed care financial analytics, managed care contracting, reimbursement analysis, or related healthcare finance role required.SkillsStrong analytical, organizational, leadership, and communication skills with advanced proficiency in Microsoft Office, Excel, and managed care reporting tools.PREFERRED QUALIFICATIONSEducationMaster’s degree in Business Administration, Healthcare Administration, Finance, Accounting, or related field preferred.ExperienceFive or more years of experience preferred, including healthcare managed care, payor contracting, reimbursement modeling, contract management systems, Epic, Power BI, SQL, SAS, or other database management tools.CORE JOB RESPONSIBILITIESPayor Contract Negotiation Support (40%)Lead contract negotiation support activities, including financial impact modeling, operational readiness planning, stakeholder coordination, and development of clear recommendations for payor contract proposals.Lead and support the Payor Strategy and Relations team in developing analytical models, coordinating project timelines, validating assumptions, and translating findings into operational recommendations that support payor contract negotiations and implementation planning.Ability to distill data to salient information and recommendations and present findings of all analyses in a logical and concise manner.Coordinate negotiation support activities across Finance, Revenue Cycle, Contracting, and operational stakeholders to ensure data requests, modeling assumptions, contract impact reviews, and deliverables are completed accurately and on schedule.Expert knowledge of reimbursement terms and methodologies for Commercial, Health Exchange, Medicaid, and Medicare product lines as well as familiarity with value-based incentive models.Manage payor strategy projects as required by the SVP and Director, including project planning, team assignments, timeline management, issue tracking, and follow-through on key deliverables.Act as a primary liaison with payors and internal stakeholders for data analytics, operational questions, issue resolution, and contract-related follow-up.Partner with SRHS Finance, Revenue Cycle, and divison teams to ensure accurate loading of payor reimbursement terms within EPIC and timely resolution of related operational issues.Identify and recommend revenue or market share growth opportunities through changes in pricing strategy or new pricing tactics.As requested by the Director, support contract language redlining, amendment development, negotiation preparation, and coordination of internal review processes.Payor Strategy Dashboards and Reports (25%)Oversee the production, maintenance, and operational use of Payor Strategy Commercial, Medicare, Medicaid, and Insurance Exchange dashboards to support leadership decision-making.Accountable for ensuring payor databases of reimbursement rates and contract terms are accurate, updated, and available to support operational and strategic decision-making.Produce reports to support leadership meetings as directed by SVP and Director. Participate in leadership meetings as requestedManage the intake, prioritization, assignment, and completion of ad hoc reporting requests, ensuring deliverables meet business needs and deadlines.Maintain Payor Strategy Insurance Plan Website in coordination with Marketing/Communications departmentAdministration of payor portals (UHC, BCBS, Availity, etc.)Payor Strategy Development (15%)Work closely with SVP and Director, to develop and update SRHS’s payor strategies to achieve SRHS goals and objectives, meet market changes, and explore new opportunities with payors.Work with SVP and Director and other key leaders providing analytic support for strategic chargemaster pricing and price transparency decisions.Work with SVP and Director in the annual SRHS budget process related to payor contracts.Assists in the development of Payor Strategy and Relations annual departmental goals.Oversee and develop benchmark studies and comparative market research needed to support Payor Strategy goals.Research pricing trends and provides recommendations on new approaches to address price transparency, shifts in the portfolio of services, trends in deductibles/co-insurance, new payment models, and value-based pricing.Contract Compliance and Performance (5%)Oversee ongoing contract performance monitoring, issue escalation, and operational follow-up with internal stakeholders and payors to support contract compliance, reimbursement accuracy, and timely resolution of identified variances.Develop and maintain reports and dashboards to monitor payor contract compliance and reporting (i.e., yield analysis, Joint Operating Committee performance metrics)Maintain Commercial, Medicare & Medicaid comparison payor reimbursement report.Participate in, review, and lead preparation for payor meetings, including Joint Operating Committees, by coordinating performance metrics, financial analyses, utilization reports, issue follow-up, and operational next steps as directed by the SVP or Director.Support the Director with contract language interpretation, contract compliance issues, escalation of operational concerns, and coordination of internal follow-up as needed.Team Support and Development (15%)Provide day-to-day division leadership for the Payor Strategy and Relations team, including workload prioritization, project oversight, issue resolution, staff development, and accountability for timely, accurate deliverables.Manage team production by prioritizing work, assigning responsibilities, monitoring progress, removing barriers, and ensuring final deliverables are complete, accurate, and timely.Coordinate with Revenue Cycle, Finance, Contracting, and operational leaders to address questions related to contract language, reimbursement rates, payor issues, and implementation impacts.Support professional growth of staff through coaching, feedback, skills development, and opportunities to lead projects or present work products.Develop a strong team environment by promoting open communication, collaboration, accountability, and constructive resolution of internal and external conflicts.WHY JOIN SPARTANBURG REGIONAL HEALTHCARE SYSTEM?Opportunity to shape payor strategy within a respected, mission-driven healthcare system.Collaborative environment where managed care expertise directly supports patient access, reimbursement performance, and organizational success.Leadership role with responsibility for team development, strategic analytics, contract support, and cross-functional problem solving.Growth potential within a large, stable, and community-focused healthcare organization.If you are ready to take the next step in your managed care leadership journey and make a meaningful impact in healthcare, we encourage you to apply today.Job SummaryJob number: P-107163Profession: Leadership & Executive CareersExperience: