Manager – Managed Care Operations

Surgery Partners, Inc

Manager of Managed Care Operations at a corporate office developing payer negotiation strategies. Collaborating with teams to achieve reimbursement goals for ambulatory surgery centers and employed physician groups.

Posted 5/20/2026full-timeNashville • Tennessee • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Develops and executes payer negotiation and contracting strategies for assigned ambulatory surgery centers (ASCs) and physician groups based on market opportunities, reimbursement goals, and organizational value proposition
Leads and manages payer contract negotiations, renewals, amendments, and ongoing agreement administration for commercial, managed Medicare, managed Medicaid, workers’ compensation, exchange, and other payer products
Partners with facility, operational, and physician leadership to implement payer strategies, address contracting challenges, and align reimbursement initiatives with facility financial and operational objectives
Works to achieve facility-specific reimbursement and budget goals through effective negotiation, contract optimization, and targeted market positioning
Analyzes payer contracts, reimbursement methodologies, and financial models to support negotiations, identify revenue opportunities, and ensure alignment with projected financial outcomes
Collaborates with revenue cycle, business office, and analytics teams to investigate and resolve complex payer issues, including underpayments, overpayments, credentialing concerns, and contract discrepancies
Monitors post-implementation contract performance to validate payer compliance, reimbursement accuracy, and consistency with modeled contract expectations
Ensures timely and accurate implementation of negotiated contract terms, automatic renewal escalators, contract system updates, and payer reimbursement changes
Maintains strong working relationships with payer representatives, provider relations contacts, and internal stakeholders including executives, CEOs/CFOs, administrators, and physician group leaders
Communicates negotiation strategies, contract status, reimbursement opportunities, and renewal timelines to internal leadership through routine updates, presentations, and operational reviews
Provides subject matter expertise and education to internal teams regarding payer trends, market developments, reimbursement changes, contract issues, and new payer products
Supports business development and strategic growth initiatives by advising on market reimbursement trends, charge strategies, fair market rates for new services, and ad hoc reporting needs

Requirements

What you’ll need

Bachelors degree required in business, technology or healthcare related field
Minimum of 3 years of experience in managed care environment
2+ years of negotiation or provider relations experience between providers and major commercial payors in markets in the U.S. and or experience in contract analysis for ASC services
Experience with ASC reimbursement methodologies
Experience working with clinically integrated networks, ACO’s, or other population health initiatives a plus
Experience working with payors and billing office staff to resolve payment discrepancies.

Benefits

Comp & perks

Comprehensive health, dental, and vision insurance
Health Savings Account with an employer contribution
Life Insurance
PTO
401(k) retirement plan with a company match
And more!

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

payer negotiationcontracting strategiescontract negotiationsreimbursement methodologiesfinancial modelscontract optimizationcontract performance monitoringcontract analysisASC reimbursementpayment discrepancy resolution

Soft Skills

leadershipcommunicationcollaborationproblem-solvingrelationship managementstrategic thinkingpresentation skillseducation and training

Certifications

Bachelor's degree