Ensign Group

Payer Strategy Lead

About the Company

ESI currently supports over 361 healthcare operations employing more than 55,000 team members across 17 states. These operations have no corporate headquarters or traditional management hierarchy. Instead, they operate independently with support from the “Service Center” — a team of dedicated accounting, legal, managed care, business development, human resources, benefits, compliance, payroll, construction, training, and information technology professionals.

Service Center human resources team members are subject matter expert consultants who guide, support, and create results in partnership with field leaders. This structure allows on-site caregivers to focus on day-to-day care delivery.

What sets ESI apart is our commitment to our mission — to dignify post-acute care in the eyes of the world through moments of trust. These moments are carried out by our most valuable resource — our people.

About the Opportunity

The Payer Strategy Lead serves as a market-level leader responsible for creating, developing, and strengthening reimbursement, contracting, and payer 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 payer models evolve.

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

Essential Functions and Responsibilities

Leadership

• Lead payer 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.

Technical

• Demonstrates advanced proficiency with Microsoft Office Suite (Excel, Word, Power BI, and Smartsheet), data collection tools, and contract management software.
• Designs and delivers high-quality presentations and training materials for both internal and external audiences.
• Serves as a subject matter expert on local, regional, and national payer environments and strategic partnerships across assigned markets and enterprise-wide initiatives.
• Possesses deep knowledge of contract negotiation, risk-based arrangements, and incentive program design, and effectively develops team capabilities in payer analysis and strategic decision-making.
• Applies comprehensive understanding of skilled nursing and assisted living billing, collections, accounting, and audit practices to inform rate setting and incentive negotiations.

Analytical

• Analyzes, interprets, and monitors key financial and operational metrics to identify trends and improvement opportunities.
• Leads data-driven decision-making for MCR/SGR teams, using analysis to guide strategy and performance across multiple facilities.
• Translates complex financial data into actionable insights, coaching team members on effective communication with operations, leadership, and interdisciplinary partners.
• Conducts root cause and trend analyses to proactively address reimbursement shifts and evolving market needs, ensuring alignment with business objectives.

Managerial

• Leads and manages the MCR and/or SGR teams, including recruiting, hiring, onboarding, training, coaching, performance evaluation, and professional development.
• Allocates and directs resources to achieve contract negotiation, partnership, and incentive program goals aligned with key performance indicators (PPD, census, and quality metrics).
• Ensures compliance with company policies, regulatory standards, and ethical guidelines, while driving timely implementation of new systems, policies, and processes.
• Cultivates a high-performance culture through clear expectations, accountability, and the development of leadership skills among direct reports.
• Performs other duties as assigned, in alignment with Ensign’s Code of Business Conduct and professional standards.

Additional Information

Salary range: $120k - $150k Depending on Experience

Position Type: Full-time, Exempt employee

Benefits: Medical, dental, vision, life & AD&D insurance plans, 401(k) with matching contribution, vacation, sick and holiday pay

Location: Candidate must reside in California

Ensign Services, Inc. is an Equal Opportunity Employer. Pre-employment criminal background screening required.