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Executive Director, Payer Relations
Location
United States
Posted
73 days ago
Salary
$103 - $172 / hour
Seniority
Lead
Job Description
Executive Director, Payer Relations
Foundation
• Function as the enterprise authority on payer operational governance, coordinating cross-functional teams to ensure payer compliance, dispute resolution, and performance improvement. • Ensure contract terms are operationalized effectively, payer obligations are enforced, financial targets are met, and performance deficiencies are escalated and resolved. • Lead market-level managed care leadership across California and CAP markets and establishes enterprise standards for payer performance oversight, contract enforcement, and managed care operational excellence. • Provide strategic direction through Directors and Senior Managers across multiple states.
Job Requirements
- Minimum Education: Master’s degree in Business, Health, or Public Administration (MBA, MHA, MPH, MPA or related field) or Juris Doctor (JD) required.
- Minimum Experience: 10+ years in managed care, payer operations, or healthcare contracting.
- 7+ years of progressive leadership experience.
- Demonstrated experience managing enterprise payer performance portfolios exceeding $1B in net revenue.
- Experience leading payer dispute resolution and contract enforcement.
- Experience working in capitated and HMO environments.
- Required Courses/Training: Membership in HFMA and/or ACHE Active in CHA and HASC managed care committees
- Preferred Experience: Oncology center or academic medical center experience.
- Experience in value-based payment models.
- Experience implementing payer performance scorecards.
Benefits
- Health insurance
- 401(k) matching
- Flexible work hours
- Paid time off
- Remote work options
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