Region Director Payer Strategy

Dignity Health; Rancho Cordova (CA); Remote; USD 100,000 - 125,000; Full time

Job summary

An established industry player seeks a dynamic Region Director for Payer Strategy to lead managed care policies and negotiate contracts across California. This remote position requires expertise in payer relationships and a strong understanding of the healthcare landscape. You will play a pivotal role in developing strategies that drive financial performance and growth, while collaborating with various stakeholders to enhance community health. If you're passionate about making a difference in healthcare and possess strong negotiation skills, this opportunity offers a chance to impact the lives of many.

Qualifications

• 5+ years of experience in managed care strategy and negotiations.
• Strong understanding of provider and payer industries.

Responsibilities

• Develop regional payer strategies and manage relationships with health plans.
• Negotiate contracts and align regional strategies with national teams.

Skills

Managed Care Strategy

Negotiation Skills

Problem-Solving

Interpersonal Skills

Education

Bachelor’s Degree in Payer Strategy or Managed Care

Job description

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Overview

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S., from clinics and hospitals to home-based and virtual care services, CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring, and our families need protection. With our combined resources, CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsibilities

This is a remote position, preferably located in California, with experience in California managed care required.

The Regional Director, Payer Strategy and Relationships (PSR), is responsible for managed care policies, contract language, reimbursement strategies, and payer relationships across California's Physician Enterprise and hospital-based clinics, comprising 12 Medical Groups with over 160 sites and 5,000 physicians. The role involves managing relationships with California health plans and IPAs, negotiating contracts, and aligning regional strategies with national teams. It is crucial for financial performance and long-term strategic growth of the organization.

• Develop regional payer strategies, relationships, and contracts to support negotiation and reimbursement goals.
• Gather and communicate insights from internal and external stakeholders to inform strategy.
• Build and maintain strategic relationships with payers, employers, and providers.
• Develop communication plans and negotiation outlines supporting payer relationships and market developments.
• Make independent decisions, stay current on industry trends, and support organizational initiatives.
• Participate in dispute resolution, joint committees, and lead sub-projects for negotiations and growth.

Qualifications

• Bachelor’s Degree or equivalent experience in payer strategy or managed care.
• At least 5 years of recent experience in managed care strategy and negotiations.
• At least 4 years of leadership and supervisory experience.

Knowledge, Skills, and Abilities

• Strong understanding of provider and payer industries.
• Excellent problem-solving, negotiation, and contractual skills.
• Ability to manage multiple priorities and work independently.
• Effective interpersonal and communication skills.

Pay Range

$59.53 - $94.00 per hour