Executive Director, Health Payer & Network Strategy

Mercy Medical Center; United States; On-site; USD 150,000 - 260,000; Full time

Job summary

Paramount Health Options is seeking an Executive Director to provide strategic leadership across PHO affiliates, aligning payer contracting, provider networks, financial stewardship, regulatory compliance, and organizational growth.

This senior healthcare executive role requires aligning operations with strategic priorities, driving quality, service excellence, and long-term sustainability while collaborating with physicians, hospitals, payers, and boards.

Qualifications

• 10+ years of progressive executive leadership in healthcare, including PHOs, CINs, IPAs, MSOs, ACOs, or managed care.
• Experience leading payer contracting and managed care strategies across commercial, Medicare, and Medicaid.
• Experience overseeing provider network strategy, credentialing, enrollment, compliance, and physician engagement.

Responsibilities

• Lead payer contracting strategy, negotiations, renewals, implementation, and ongoing contract performance oversight.
• Oversee provider network development, credentialing, delegated credentialing, enrollment, roster accuracy, and provider relations.
• Manage organizational financial performance, budgeting, reporting, investment oversight, and resource stewardship.
• Support Board and committee governance through clear reporting, strategic recommendations, and execution of approved priorities.
• Ensure compliance with regulatory, payer, accreditation, NCQA, HIPAA, and delegated credentialing requirements with emphasis on continuous quality improvement.
• Lead staff, strengthen operational processes, foster service excellence, and advance member satisfaction and organizational performance.

Skills

Payer contracting strategy

Provider network development

Regulatory compliance

Financial stewardship

Executive leadership

Education

Bachelor's degree in Healthcare Administration/Business/Finance/Public Health

Master's degree in Healthcare Administration/MBA/MPH

Job description

Paramount Health Options is seeking an Executive Director to provide strategic leadership across PHO affiliates, aligning payer contracting, provider networks, financial stewardship, regulatory compliance, and organizational growth.

This senior healthcare executive role requires aligning operations with strategic priorities, driving quality, service excellence, and long-term sustainability while collaborating with physicians, hospitals, payers, and boards.