Regional Director of Payer Strategies

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

📋 Description

• Formulate and implement strategies for managed care and commercial payers in collaboration with regional CFOs and CEOs.

• Negotiate contracts with regional managed care and commercial payers using standardized language and reimbursement methods.

• Ensure alignment of contracts with the strategies of the regional health ministry.

• Foster relationships with hospital leadership, Revenue Excellence, System Office, Legal, and senior payer executives.

• Operationalize and apply managed care contracts and updates within hospitals and Revenue Excellence.

• Oversee programs, denial management, payer compliance, and the financial and operational performance of payers.

• Communicate and implement changes in payer policies while providing additional training as necessary.

• Identify opportunities for payer collaboration and execute collaborative initiatives.

• Act as a liaison between hospitals and regional payers.

• Deliver regular payer reporting packages, including payer report cards, to the hospital C-suite and Revenue Excellence leaders.

• Create and maintain market profiles for key payers, buyers, and brokers.

• Develop, implement, and oversee payer pay-for-performance programs.

• Collaborate with hospital clinical leadership to optimize revenue realization.

• Supervise and mentor regional payer contracting staff.

• Prepare budgets and manage resources to align with budgetary targets.

• Ensure adherence to relevant laws, regulations, Trinity Health policies, and the Code of Conduct.

⛳️ Requirements

• In-depth understanding of healthcare finance, managed care, and insurer contracting.

• A Bachelor’s degree in Business Administration is typically required.

• Eight to ten years of experience in healthcare, with substantial experience in managed care and other payer interactions.

• A Master’s in Business Administration or a Master’s in Health Administration is preferred.

• Professional certifications such as FHFMA, FACHE, or FAHM are preferred.

• Demonstrated expertise in contract negotiation.

• Strong analytical capabilities.

• Excellent written and verbal communication skills.

• Ability to function effectively in a collaborative, shared leadership environment.

• Personal attributes marked by honesty, integrity, and compassion, with the capacity to inspire and motivate others.

• Familiarity with applicable Federal, State, and local laws and regulations, as well as Trinity Health’s Integrity and Compliance Program, Code of Conduct, policies, and procedures.

🏝️ Benefits

• Remote work arrangement

• Equal Opportunity Employer