Executive Director, Payer Relations
Foundation
full-time
Posted on:
Location Type: Remote
Location: United States
Visit company websiteExplore more
Salary
💰 $103 - $173 per hour
Job Level
About the role
- Function as the enterprise authority on payer operational governance, coordinating cross-functional teams to ensure payer compliance, dispute resolution, and performance improvement.
- Ensure contract terms are operationalized effectively, payer obligations are enforced, financial targets are met, and performance deficiencies are escalated and resolved.
- Lead market-level managed care leadership across California and CAP markets and establish enterprise standards for payer performance oversight, contract enforcement, and managed care operational excellence.
- Provide strategic direction through Directors and Senior Managers across multiple states.
Requirements
- Master’s degree in Business Administration, Health Administration, Public Health, or Public Administration
- 10+ years in managed care, payer operations, or healthcare contracting
- 7+ years of progressive leadership experience
- Experience managing enterprise payer performance portfolios exceeding $1B in net revenue
- Experience leading payer dispute resolution and contract enforcement
- Experience working in capitated and HMO environments
- Membership in HFMA and/or ACHE
- Active in CHA and HASC managed care committees
Benefits
- Comprehensive Benefits
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
payer operationshealthcare contractingmanaged carecontract enforcementdispute resolutionperformance improvementfinancial targetsenterprise payer performancecapitated environmentsHMO environments
Soft Skills
leadershipstrategic directioncross-functional coordinationperformance oversightproblem-solvingcommunicationteam managementoperational excellenceescalation managementcollaboration
Certifications
Master’s degree in Business AdministrationMaster’s degree in Health AdministrationMaster’s degree in Public HealthMaster’s degree in Public AdministrationHFMA membershipACHE membershipCHA membershipHASC membership