Nicole Hughes
Hiram,GA
Summary
Strategic healthcare executive with 10+ years of success in payer relations, managed care, and business development across diverse care settings. Skilled in optimizing contracts, building high-impact networks, and driving growth in regulated markets. Proven track record navigating Medicare, Medicaid, and commercial payors to deliver sustainable revenue and operational excellence.
Overview
16
16
years of professional experience
Work History
Director of Sales and Marketing
Carenbe
05.2024 - Current
- Lead the development and execution of growth-focused marketing and payer engagement strategies.
- Forge relationships with commercial and government payors to expand service lines and revenue.
- Collaborate across clinical, operational, and finance teams to align contract performance with KPIs.
- Ensure compliance with all regulatory and contractual obligations, including payer credentialing.
Regional Director of Sales
Aurora Cares – Tara Cares
06.2021 - 05.2024
- Managed payer relations, network development, and admissions strategy across seven facilities.
- Identified and negotiated favorable commercial managed care agreements to expand network access and improve reimbursement.
Director of Business Development
Passion to Care
09.2020 - 06.2021
- Launched a Medicaid waiver program and built intake and admissions systems from the ground up.
- Led payer outreach and built new relationships with MCOs to support enrollment and service delivery.
- Developed scalable marketing and contracting processes aligned with program expansion.
Regional Director of Admissions and Sales
PruittHealth
12.2017 - 08.2020
- Directed network development and managed care strategy for 13 SNFs.
- Oversaw pre-admission eligibility, contract utilization, and care transitions.
- Trained staff on payer-specific workflows and compliance requirements.
Director of Sales
Medside Healthcare
12.2014 - 12.2017
- Established the organization’s marketing and managed care relationship infrastructure.
- Created KPI frameworks to evaluate payer performance and support referral growth.
- Grew referrals 300% through targeted payer and provider engagement strategies.
Regional Director of Managed Care
Sava Senior Care
07.2011 - 11.2014
- Oversaw managed care strategy for 100+ SNFs in 10 states.
- Negotiated payer contracts, rate adjustments, and value-based care initiatives.
- Drove market share through strategic contracting and cross-functional coordination.
- Ensured full compliance with payer credentialing, authorization, and reimbursement protocols.
Regional Sales Manager
Sava Senior Care
07.2009 - 07.2014
- Led multi-state sales teams and executed turnaround strategies for underperforming markets.
- Supported new market launches and payer contract implementations.
Skills
- Managed Care & Payer Contracting
- Network Development & Expansion
- Value-Based Payment Models
- Credentialing & Compliance Oversight
- Revenue Growth Strategy
- Cross-Functional Leadership
- Healthcare Policy & Reimbursement Models
- 340B Program Awareness & Integration
- Data-Driven Decision Making
- Strategic Partnerships & Joint Ventures
- Sales coaching
- Pricing strategy
- Partnership development
- Sales presentations
Timeline
Director of Sales and Marketing
Carenbe
05.2024 - Current
Regional Director of Sales
Aurora Cares – Tara Cares
06.2021 - 05.2024
Director of Business Development
Passion to Care
09.2020 - 06.2021
Regional Director of Admissions and Sales
PruittHealth
12.2017 - 08.2020
Director of Sales
Medside Healthcare
12.2014 - 12.2017
Regional Director of Managed Care
Sava Senior Care
07.2011 - 11.2014
Regional Sales Manager
Sava Senior Care
07.2009 - 07.2014
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