Director, Payer Performance

Community Medical Centers; Fresno (CA); On-site; USD 150,000 - 210,000; Full time

Job summary

Community Medical Centers in Fresno, CA seeks a Director of Payer Performance to lead strategy, analytics, and optimization of payer reimbursement and contract performance across the health system.

You will partner with Finance, Managed Care, Legal, Compliance and executive leadership to translate complex data into actionable insights, oversee denial management, contract modeling, and revenue leakage identification, while guiding a high-performing team.

Qualifications

• Bachelor's degree in healthcare administration, business, finance, accounting, or related field.
• 5+ years of healthcare revenue cycle or payer-related experience.
• 3+ years of management or leadership experience in a healthcare or payer environment.
• Experience developing performance dashboards and executive reporting.
• Experience with revenue cycle analytics, business intelligence, or data visualization platforms.

Responsibilities

• Lead the strategy, analytics, and optimization of payer reimbursement and contract performance across the health system.
• Partner with Finance, Managed Care, Legal, Compliance and executive leadership to translate complex data into actionable insights.
• Oversee payer performance analytics, denial management, contract modeling, and revenue leakage identification; drive issue resolution.
• Support contract negotiations and renewal strategies; ensure regulatory compliance and governance.

Skills

Payer analytics

Revenue cycle

Leadership

Dashboard development

Executive reporting

Education

Bachelor's degree in healthcare administration, business, finance, accounting, or related field

Tools

BI platforms

Data visualization

Job description

Overview

Opportunities for you!

• Recognized by Newsweek as one of America's Greatest Workplaces for 2026
• Eligible for annual incentive program, progressive sign-on incentive and comprehensive relocation package
• Community University leadership training courses
• Tuition reimbursement, education programs and scholarships
• Vacation time accrues from Day 1 at the maximum allowable accrual rate
• Free money toward retirement with a 403(b) and matching contributions
• Great on-demand dining options, plus free parking and EV charging ordering

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

Responsibilities

As 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

Disclaimers

Pay ranges listed are an estimate and subject to change. If any bonuses are noted, they are only applicable to external hires meeting criteria.