VP, Ophthalmology Payer Strategy

US Eye; United States; On-site; USD 180,000 - 280,000; Full time

Job summary

US Eye is seeking a Vice President of Payer Relations to lead the organization’s payer strategy across ophthalmology practices and affiliated services. This executive will oversee contracting, reimbursement analysis, and network participation to support growth and appropriate payment for services.

Working with senior leaders, this role translates payer dynamics into actionable plans, builds strong payer relationships, and drives performance through data-driven insights, governance, and

Qualifications

• Bachelor’s degree in healthcare administration, business administration, finance, economics, or related field.
• Eight or more years of progressive experience in payer relations, managed-care contracting, reimbursement strategy, healthcare finance, revenue cycle, or a related field.
• Demonstrated ability to interpret complex contract language, fee schedules, reimbursement methodologies, and payer policies.
• Master’s degree preferred; five or more years of leadership experience preferred.
• Experience negotiating payer contracts for a multi-location medical practice, specialty physician group, ambulatory surgery center organization, or healthcare system strongly preferred.

Responsibilities

• Develop and lead payer-relations strategy aligned with clinical, operational, and financial goals.
• Advise executive leadership on payer trends, reimbursement risks, contracting opportunities, and market developments.
• Establish priorities for payer negotiations based on reimbursement performance, patient access, geographic expansion, service-line growth, and organizational needs.
• Evaluate the financial and operational impact of payer policies, contract terms, and reimbursement changes.
• Support strategic planning for new practice locations, physician groups, ambulatory surgery centers, and other affiliated services.
• Represent the organization in executive-level discussions with health plans and other payer partners.
• Lead negotiations for commercial, Medicare Advantage, managed Medicaid, and other applicable payer agreements.
• Evaluate contract terms, reimbursement methodologies, fee schedules, payment policies, network requirements, and administrative provisions.
• Partner with Finance and Revenue Cycle leadership to model the financial impact of proposed agreements and contract amendments.
• Ensure contracts support appropriate reimbursement for ophthalmology services, including office visits, diagnostic testing, procedures, surgical services, and specialty care.
• Maintain a centralized process for monitoring contract terms, renewal dates, amendments, notice periods, and key obligations.
• Identify opportunities to improve reimbursement, strengthen contract language, and reduce administrative burden.
• Coordinate with legal counsel as appropriate when reviewing or negotiating agreements.
• Build and maintain productive relationships with payer executives, provider-relations representatives, contracting teams, and medical-management leaders.
• Serve as an escalation point for high-impact payer issues affecting reimbursement, patient access, claims processing, prior authorization, or provider participation.
• Conduct regular payer meetings and business reviews to address performance, policy changes, operational concerns, and opportunities for collaboration.
• Promote timely communication between payers and internal stakeholders.
• Develop strategies to strengthen payer partnerships while protecting the organization’s financial and operational interests.

Skills

Negotiation

Leadership

Strategic thinking

Communication

Education

Bachelor’s degree in healthcare administration or related field

Master’s degree preferred

Tools

Microsoft Office

Contract-management tools

Reporting and analytics tools

Job description

US Eye is seeking a Vice President of Payer Relations to lead the organization’s payer strategy across ophthalmology practices and affiliated services. This executive will oversee contracting, reimbursement analysis, and network participation to support growth and appropriate payment for services.

Working with senior leaders, this role translates payer dynamics into actionable plans, builds strong payer relationships, and drives performance through data-driven insights, governance, and