Payor Strategy Lead
Position Type: Full-time, Exempt employee.
Salary: $120,000 - $150,000 annually, DOE.
Location: Candidate must reside in California.
About the Company:
Ensign Services, Inc. ("ESI") is a subsidiary of The Ensign Group, Inc. whose affiliated entities are considered national leaders in the fast-growing post-acute care industry. ESI provides service and support to over 378 facilities in the long-term care continuum that employ over 55,000 employees.
ESI is known as the "Service Center" and provides the facilities and leaders it serves with "back-office" support in areas such as accounting, construction, compliance, human resources, information technology, learning and development, legal and risk management and recruiting. This structure allows the onsite leaders and caregivers to focus on day-to-day care and operational issues in their individual operations. What sets ESI apart from other companies is the quality of our most valuable resource - our people.
We take our core values of
Celebration,
Accountability,
Passion for Learning,
Love One Another,
Intelligent Risk Taking,
Customer Second, and
Ownership ("CAPLICO") seriously. We want an individual in this role who will demonstrate these values through actions and words.
About the Opportunity:
The
Payor Strategy Lead serves as a market-level leader responsible for creating, developing, and strengthening reimbursement, contracting, and Payor relationships. As a team leader, this individual provides strategic direction, supervision, and training to Managed Care Resources (MCR) and Strategic Growth Resources (SGR) across a defined region of skilled nursing operations.
Key responsibilities include
developing, expanding, and optimizing payment models for each operation - including contracts with managed care organizations, Medicare value-based programs, and strategic partnerships with hospitals and physician groups.
The ideal candidate is a
culture champion who demonstrates strong leadership, collaboration, and communication skills, with a passion for driving positive clinical and financial outcomes. This role requires an
innovative thinker who can educate and empower teams as Payor models evolve.
Job Duties and Responsibilities include, but are not limited to:
- Lead Payor strategy within assigned geography, providing both hands-on system/process oversight and direct supervision of a diverse MCR/SGR team.
- Act as a proactive liaison with Operations and MCR/SGR resources to identify opportunities, address root causes, and coordinate solutions.
- Collaborate with interdisciplinary teams and escalate systemic issues to operational leadership as needed.
- Travel up to 70% within the U.S. to deliver world-class leadership and service. (Travel will be dependent on your physical presence to the locations that you serve).
- Actively participate in state and national healthcare associations and subcommittees when opportunities arise.
- Demonstrate advanced proficiency with Microsoft Office Suite (Excel, Word, Power BI, and Smartsheet), data collection tools, and contract management software.
- Designs and deliver high-quality presentations and training materials for both internal and external audiences.
- Serve as a subject matter expert on local, regional, and national Payor environments and strategic partnerships across assigned markets and enterprise-wide initiatives.
- Possess deep knowledge of contract negotiation, risk-based arrangements, and incentive program design, and effectively develops team capabilities in Payor analysis and strategic decision-making.
- Apply comprehensive understanding of skilled nursing and assisted living billing, collections, accounting, and audit practices to inform rate setting and incentive negotiations.
- Analyze, interpret, and monitor key financial and operational metrics to identify trends and improvement opportunities.
- Lead data-driven decision-making for MCR/SGR teams, using analysis to guide strategy and performance across multiple facilities.
- Translate complex financial data into actionable insights, coaching team members on effective communication with operations, leadership, and interdisciplinary partners.
- Conduct root cause and trend analyses to proactively address reimbursement shifts and evolving market needs, ensuring alignment with business objectives.
- Lead and manage the MCR and/or SGR teams, including recruiting, hiring, onboarding, training, coaching, performance evaluation, and professional development.
- Allocate and direct resources to achieve contract negotiation, partnership, and incentive program goals aligned with key performance indicators (PPD, census, and quality metrics).
- Ensure compliance with company policies, regulatory standards, and ethical guidelines, while driving timely implementation of new systems, policies, and processes.
- Cultivate a high-performance culture through clear expectations, accountability, and the development of leadership skills among direct reports.
- Perform other duties as assigned, in alignment with Ensign's Code of Business Conduct and professional standards.
Preferred Qualifications:
- Experience in skilled nursing facility management preferred (e.g., Executive Director, Director of Therapy Services, Director of Nursing, Regional Revenue Strategist, AR or Managed Care Specialist).
- Minimum of 5 years of relevant financial and management experience, including multi-site leadership (preferably in a geographically diverse organization).
- Bachelor's degree in a healthcare, finance, or business-related field.
Additional Information:
- Pre-employment criminal background screening required.
What We Offer:
We are committed to providing a competitive benefits and compensation package which includes medical/dental/vision coverage, company-provided life insurance, 401(k) with company match, and sick/vacation plans. We also believe in supporting our employee's professional growth and development through our Learning Management System as well as training sessions and seminars. Take a look at these benefits (and more!) at www.ensignbenefits.com.
Ensign Services, Inc. is an equal opportunity employer. If you need assistance or accommodation during the application process, please contact us at 888-659-3616.
Job ID 1115