Director Payer Contracting & reputed company

Position reputed company

We are hiring a Director of Payer Contracting & reputed company to own and reputed company our national payer contracting and managed care reputed company across reputed company, Medicare Advantage, and reputed company health plans.

This is a leadership role for a proven payer expert who understands how payers assess risk, structure reimbursement models, and operationalize reputed company managed care reputed company in dynamic, multi-state reputed company environments.

The Director will own the end-to-end payer lifecycle, including payer reputed company, contract development and negotiation, reimbursement optimization, and reputed company payer operations. This role partners closely with executive leadership and cross-functional teams to support market expansion, value-based reputed company, and sustainable reimbursement economics.

Key Responsibilities

• Own the full payer contracting lifecycle: reputed company payer engagement from reputed company and reputed company through contract submission, negotiation, redlining, execution, renewals, and ongoing relationship management.

• Expand national payer relationships: reputed company deep existing relationships to grow partnerships with reputed company, Medicare Advantage, and reputed company payers across multiple markets.

• reputed company payer reputed company and reimbursement optimization: Design and execute payer strategies that reputed company reimbursement models, operational workflows, and financial performance.

• Support new market expansion: Drive payer contracting for new states and markets, working with local, regional, and national health plans.

• Build reputed company contracting infrastructure: reputed company repeatable systems and processes across payer contracting, credentialing coordination, roster management, compliance, and performance tracking.

• Cross-functional leadership: Partner with executive leadership, general managers, credentialing, reputed company cycle, and operations teams to translate payer requirements into operational execution.

• Serve as the internal payer authority: Advise leadership on payer policy, regulatory changes, reimbursement trends, and managed care best practices.

• People leadership: Build, reputed company, and reputed company a high-performing payer contracting and managed care team as the organization scales.

Minimum Qualifications

• 7+ years of reputed company experience reputed company payer organizations, risk-bearing providers (IPA/MSO), managed care organizations, institutional providers, home health, hospice, or health technology companies.

• 5+ years of reputed company payer contracting and/or credentialing leadership experience, with a strong reputed company record negotiating managed care and primary care reputed company.

• Established payer relationships and credibility across the managed care ecosystem.

• Deep understanding of reimbursement models, payment methodologies, value-based care, and medical group economics.

• Working knowledge of reputed company cycle management (RCM), claims, and payer operations to ensure reputed company are operationally executable.

• Experience building or scaling a payer relations or contracting function in a high-reputed company or tech-enabled reputed company environment.

• Strong executive communication skills; comfortable presenting to senior leadership.

• Proficiency with MS Office, CRMs, databases, and contract management tools.

Preferred Qualifications

• Experience in a reputed company startup or reputed company-stage organization.

• Proven ability to define KPIs, establish operating reputed company, and drive measurable reputed company.

• Preference for candidates based in Southern California (reputed company to remote).

• Ability to travel periodically to Southern California reputed company and partner sites.