Director of Payor Relations
New
M
Metro Vein CentersHealthcare
Remote, USFull-TimeDirector
Salary not disclosed
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Job Details
- Experience
- 8+ years
- Required Skills
- Tableau
Requirements
- Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field (Master’s degree preferred).
- 8+ years of progressive experience in managed care contracting, payor relations, or healthcare revenue cycle within a multi-site or multi-state organization.
- Demonstrated history of managing or leading teams, functions, or cross-functional initiatives.
- In-depth knowledge of commercial payor structures, Medicare Advantage, and Medicaid managed care variations.
- Proven track record of negotiating and executing complex payor contracts with measurable, positive revenue impact.
- Strong analytical skills with the ability to model contract scenarios and translate claims data into actionable strategy.
- Proficiency with contract modeling tools, RCM systems, and analytics platforms (e.g., Tableau).
- Excellent communication and relationship-building skills across payor executives and internal stakeholders.
- Demonstrated ability to manage multiple complex projects with minimal oversight.
- Experience in a PE-backed, multi-state healthcare organization, MSO, specialty medical group, or ASC environment.
Responsibilities
- Serve as the single point of accountability for all payor relationships, contracts, negotiations, and strategic initiatives across an assigned regional portfolio.
- Lead payor contract negotiations across all commercial, Medicare Advantage, and Medicaid managed care plans within the assigned region.
- Interpret payor contract terms and translate them into standardized operational guidance for Revenue Cycle, Finance, and Operations teams.
- Develop and maintain financial models, benchmarking analyses, and rate impact assessments to support regional negotiations and executive reporting.
- Execute regional payor strategy aligned with enterprise growth targets, revenue goals, and market expansion plans.
- Lead cross-functional communication and process standardization related to payor requirements and contract interpretation.
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