Senior Director, Payor Relations

Virginia Hospital & Healthcare Association (VHHA); Glen Allen (VA); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Competitive benefits package

Incentive plan opportunity

Job summary

A regional healthcare association in Glen Allen, Virginia is seeking a Senior Director of Payor Relations to lead initiatives with Virginia's health insurers. The ideal candidate will have at least 5 years of experience in commercial health insurance and a strong ability to communicate and problem-solve effectively. This full-time position involves travel within the Richmond metro area and offers competitive compensation along with a benefits package.

Qualifications

• Minimum 5 years of experience with commercial health insurers, payor contracting, or regulatory oversight.
• Extensive experience with health insurance business and contracting matters.
• Working knowledge of Medicaid managed care and Medicare Advantage.

Responsibilities

• Serve as the lead member on all matters involving commercial health insurers in Virginia.
• Coordinate and facilitate VHHA Payor Advisory Committee meetings.
• Foster strong working relationships with insurance representatives.

Skills

Communication Skills

Problem Solving

Ability to Work Independently

Proficient in Microsoft Office Suite

Education

Bachelor's Degree

Job description

2 days ago Be among the first 25 applicants

The Virginia Hospital & Healthcare Association (VHHA) is seeking candidates for Senior Director, Payor Relations at our headquarters in Glen Allen, Virginia. Under the direction of the President & CEO, the Senior Director of Payor Relations works to advance the interests of Virginia’s hospitals and health systems with commercial payors (including Medicaid managed care and Medicare Advantage) through ensuring an effective working relationship with Virginia health insurers and developing and implementing strategies to promote patient and provider-friendly contracting and reimbursement policies.

Roles & Responsibilities

• Serve as the lead VHHA team member on all matters involving commercial health insurers (including Medicaid managed care and Medicare Advantage) in Virginia.
• Advises VHHA’s leadership and VHHA members on payor policies, contracting, network adequacy, reimbursement, and other matters.
• Coordinate and facilitate VHHA Payor Advisory Committee (PAC) meetings while maintaining compliance with antitrust requirements.
• Write and publish a monthly newsletter for VHHA members on payor-related matters.
• Foster and maintain strong working relationships with representatives from Virginia health insurers and regulatory bodies with oversight over health insurers.
• Work with VHHA’s advocacy and policy team to develop legislative and regulatory proposals related to the insurance industry.
• Represent VHHA and its members on regulatory committees and work groups applicable to health insurance and payor issues.
• Review legislation and regulations related to the insurance industry, advise the advocacy and policy team during General Assembly sessions, and assist with the development of collateral materials related thereto.
• Perform the role of VHHA lead for all functions related to the payor scorecard initiative, including analyses for members and facilitating a scorecard user group.
• Coordinate with VHHA’s Senior Vice President and General Counsel and others on matters before the State Corporation Commission’s Bureau of Insurance.
• Monitor national trends in payor contracting, network adequacy, reimbursement, and other policies to anticipate potential future matters to address in Virginia.
• Represent VHHA on multi-state state hospital association and national hospital association workgroups and at other meetings related to health insurers and payor policies.
• From time to time, supervise outside contractors that are engaged to assist with payor-related matters.
• Support, organize, and manage rapidly changing priorities and crisis situations in a focused and professional manner.

Qualifications

• Minimum 5 years of experience working with commercial health insurers, hospital/health system payor contracting/relations, or a regulatory body with oversight of commercial health insurers.
• Extensive experience with commercial health insurance business, contracting, financial, and operational matters.
• Working knowledge of Medicaid managed care and Medicare Advantage.
• Strong written and verbal communication skills and ability to solve and resolve problems in a timely manner.
• Ability to work independently, set priorities, and complete assigned tasks with minimal supervision.
• Proficiency in Microsoft Office Suite.
• A bachelor’s degree.
• Full‑time position requiring travel within the Richmond metro area, occasional travel within Virginia and Washington, DC, and occasional overtime and weekend hours.

Compensation & Benefits

Compensation will be commensurate with work experience and VHHA offers a competitive benefits package and incentive plan opportunity.

How to Apply

Interested candidates should send a cover letter and resume to [e-mail].

Equal Opportunity Employer

VHHA is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, sex, national origin, age, disability, marital status, military service or veteran status, sexual orientation, gender identity, genetic information, pregnancy, childbirth or related medical conditions, including lactation, political affiliation or other basis prohibited by federal or state law relating to discrimination in employment.

It is the policy of VHHA to provide a drug‑free workplace in keeping with the spirit and intent of the Drug Free Workplace Act of 1988. VHHA prohibits the manufacture, sale, distribution, dispensation, possession, or use of alcohol, controlled substances, or marijuana on VHHA premises or while conducting VHHA business on or off VHHA premises.