Director, CMS & Provider Direct Channel

This is a fully remote position, open to applicants in Kentucky.

📋 Description

• Spearhead the strategy and implementation for the CMS & Provider Direct Channel, which encompasses CMS compliance APIs, voluntary interoperability features, and direct-to-provider connectivity.

• Take ownership of channel performance regarding regulatory delivery, provider engagement, and the continual expansion of the channel.

• Convert CMS requirements, policy directives, and enterprise goals into actionable channel strategies and executable roadmaps.

• Collaborate across product, technology, operations, compliance, legal, and business teams to provide compliant, scalable, and provider-ready capabilities.

• Promote the adoption of CMS and direct connectivity solutions by aligning channel functionalities with provider needs and business objectives.

• Supervise the execution of provider-facing APIs and direct exchange functionalities that enhance access, minimize friction, and facilitate interoperability at scale.

• Establish and oversee KPIs for channel preparedness, compliance execution, adoption, utilization, and overall performance.

• Assist in external engagements associated with CMS mandates, voluntary commitments, and opportunities for direct provider connectivity.

• Recognize risks, dependencies, and execution obstacles early on, driving cross-functional resolutions.

• Lead and nurture a strong team focused on channel delivery, partner coordination, and execution management.

• Continuously evaluate regulatory changes, market dynamics, and provider demand to enhance channel performance over time.

⛳️ Requirements

• Bachelor’s degree in business, healthcare administration, or a related discipline.

• Over 6 years of progressive leadership experience in interoperability, digital health, healthcare technology, product management, regulatory delivery, or similar functions, preferably in the healthcare sector.

• Experience in leading the delivery of API-based capabilities, regulatory initiatives, or provider-facing interoperability solutions.

• Strong grasp of CMS interoperability requirements, healthcare data exchange, provider workflows, and operational execution.

• Proven capability to lead across business, compliance, operational, and technology teams.

• Demonstrated ability to analyze complex issues, communicate effectively, and drive solutions.

• A solid track record of executing in complex, cross-functional environments.

🏝️ Benefits

• Medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave).

• Short-term and long-term disability.

• Life insurance.

• Many other opportunities.