ResponsibilitiesAs the Director of Payer Performance, you will lead the strategy, analysis, and optimization of payer reimbursement and contract performance to drive revenue integrity and growth across the health system. You'll serve as a key partner to Finance, Managed Care, Legal, Compliance, and executive leadership, translating complex payer, contractual, financial, and operational data into actionable insights and strategies. In this role, you'll oversee payer performance analytics, reimbursement variance reviews, denial management, contract modeling, and revenue leakage identification, while leading efforts to resolve underpayments, payment discrepancies, and other payer-related issues. Additionally, you will support contract negotiations and renewal strategies, ensure compliance with regulatory requirements, and develop a high-performing team focused on enhancing payer accountability and improving overall financial performance.
Qualifications
- Bachelor’s Degree in healthcare administration, Business Administration, Finance, Accounting, or related field required
- Five (5) years of healthcare revenue cycle or payer-related experience required
- Three (3) or more years of management or leadership experience in a healthcare or payer environment required
- Experience developing performance dashboards and executive reporting required
- Experience with revenue cycle analytics, business intelligence, or data visualization platforms required
