Director of Payer Relations & Contracting in United States at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Director of Payer Relations & Contracting in United States.

This role is a high-impact leadership position responsible for shaping and executing national and regional payer strategies within a growing healthcare organization. The Director of Payer Relations & Contracting leads critical negotiations with commercial, Medicare Advantage, and Medicaid payers to ensure optimal reimbursement and strong network positioning. This position plays a central role in strengthening payer partnerships, expanding contract coverage, and improving revenue performance across a post-acute care footprint. It requires a strategic mindset combined with strong analytical and negotiation capabilities, as well as the ability to operate effectively in a matrixed healthcare environment. The role works closely with executive leadership, finance, operations, and revenue cycle teams to drive contract optimization and resolve reimbursement challenges. This is a highly visible position with direct influence on organizational growth, financial performance, and payer ecosystem strategy.

• Develop and execute national and regional payer contracting strategies to expand network access and optimize reimbursement performance.
• Lead negotiations with commercial, Medicare Advantage, and Medicaid payers to secure favorable contract terms, rates, and value-based arrangements.
• Manage the full lifecycle of payer contracts, including evaluation, performance monitoring, compliance, and optimization opportunities.
• Analyze reimbursement structures and financial performance to identify margin improvement and operational efficiency opportunities.
• Build and maintain strong relationships with payer executives and network management teams, serving as the primary organizational liaison.
• Lead high-level payer meetings, presentations, and negotiations to resolve issues and strengthen partnerships.
• Collaborate with revenue cycle, billing, and operations teams to address denials, underpayments, and reimbursement discrepancies.
• Support revenue integrity initiatives by improving claims performance and payment resolution processes.
• Monitor market trends, regulatory changes, and competitive dynamics impacting payer strategy and reimbursement models.
• Support mergers, acquisitions, and market expansion efforts through payer contract assessment and integration planning.
• Provide regular reporting to senior leadership on payer strategy performance, risks, and opportunities.

• Bachelor’s degree in business, healthcare administration, or related field preferred, or equivalent experience.
• 5+ years of experience in payer relations, managed care contracting, or post-acute healthcare environments.
• Strong experience with Durable Medical Equipment (DME), infusion therapy, or similar post-acute care services preferred.
• Proven track record of successful payer negotiations and contract management across commercial and government payers.
• Deep understanding of reimbursement methodologies, managed care structures, and payer systems (Medicare, Medicaid, commercial).
• Strong financial, analytical, and problem-solving skills with the ability to interpret complex contract structures.
• Experience identifying and resolving reimbursement issues such as denials and underpayments.
• Excellent communication, relationship-building, and stakeholder influence skills across executive-level audiences.
• Ability to work independently in a fast-paced, matrixed environment while managing multiple priorities.
• Willingness to travel approximately 25% as needed.

• Competitive compensation package with performance-based incentives
• Comprehensive health coverage including medical, dental, and vision insurance
• Life insurance and short- and long-term disability coverage
• Generous paid time off and paid holidays
• 401(k) retirement plan with employer match
• Opportunity to shape payer strategy in a high-growth healthcare organization
• High-visibility leadership role with direct impact on revenue and market expansion
• Collaborative executive environment with strong operational support