Payer Strategy & Contracts Director

Central Health; Austin (TX); Vor Ort; USD 180.000 - 260.000; Vollzeit

Zusammenfassung

Central Health in Austin, TX seeks a Director of Payer Strategy & Contracting to lead the development, negotiation, and ongoing management of payer agreements across Medicaid, Medicare, MCOs, and commercial payers.

The role partners with executive leadership and finance, analytics, and operations to optimize reimbursement, ensure regulatory compliance, and drive value-based care initiatives.

Qualifikationen

• 7 years of progressive payer contracting experience in healthcare.
• Experience negotiating with Medicaid, Medicare, Managed Care Organizations, and commercial payers.
• Experience designing or managing value-based care arrangements or alternative payment models.

Aufgaben

• Lead payer contracting strategy, negotiations, renewals, amendments, and escalations.
• Develop contracting strategies to maximize reimbursement and financial sustainability.
• Model financial impact and analyze performance using data and dashboards.
• Coordinate with Revenue Cycle, Finance, Compliance, Population Health and Analytics to implement terms.
• Oversee payer enrollment activities and ensure regulatory compliance.
• Provide internal education on payer terms and reimbursement methodologies.

Kenntnisse

Payer contracting

Negotiation

Value-based care

Financial modeling

Stakeholder mgmt

Regulatory compliance

Risk assessment

Ausbildung

Bachelor's Degree in Business/Healthcare Administration/Finance

Jobbeschreibung

Central Health in Austin, TX seeks a Director of Payer Strategy & Contracting to lead the development, negotiation, and ongoing management of payer agreements across Medicaid, Medicare, MCOs, and commercial payers.

The role partners with executive leadership and finance, analytics, and operations to optimize reimbursement, ensure regulatory compliance, and drive value-based care initiatives.