Director Payer Strategy jobs in United States
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Novant Health · 4 months ago

Director Payer Strategy

Novant Health is a healthcare organization focused on delivering exceptional patient experiences. They are seeking a Director of Payer Strategy to lead payer accountability, manage contract performance, and optimize revenue cycle functions while ensuring compliance with healthcare regulations.

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H1B Sponsor Likelynote

Responsibilities

Develop and implement strategies to maximize revenue from payers, including negotiating favorable contracts and identifying areas for improvement in reimbursement processes
Provide strategic direction and leadership to the payer strategy and defense audit team, ensuring alignment with the overall goals of the revenue cycle department. Serve as the primary liaison to payers
Oversee payer relationships and ensure compliance with contract terms, conditions, and performance standards. Establish regular business reviews with payers to monitor contract adherence, resolve disputes and address operational issues
Monitor and manage the performance of payer contracts to ensure optimal financial outcomes. Identify and address any issues or discrepancies in under or over payments
Work closely with other departments within the organization to ensure seamless coordination and integration of payer strategies with other revenue cycle functions. Collaborate with finance, revenue cycle, and clinical teams to ensure payment terms escalators and incentives are being realized
Collaborate with revenue cycle teams, payers, and internal stakeholders to analyze overpayment trends, determine root causes, and implement preventative measures to reduce future overpayments and optimize revenue capture
Analyze data to assess contract performance and payer compliance. Prepare payer scorecards and present reports to senior management. Analyze payer reimbursement patterns, denial trends, and claims data to identify opportunities for revenue enhancement and process improvements
Identify opportunities for process improvements and implement strategies to enhance payer performance and accountability
Ensure adherence to all relevant healthcare regulations, billing guidelines and payer policies to minimize compliance risks and maximize revenue
Develop and execute payer contracting strategies that optimize reimbursement and revenue while ensuring strict adherence to all applicable federal and state healthcare regulations. Collaborate closely with Legal and Compliance teams to interpret new regulations, assess contractual risks, and proactively adjust payer strategies and related revenue cycle processes to maintain compliant operations and mitigate financial and legal liabilities

Qualification

Payer strategyContract managementRevenue cycle managementData analysisHealthcare regulationsLeadershipCommunication skillsOrganizational skills

Required

Strong analytical, organizational, and communication skills
Proven ability to lead teams and manage projects effectively
In-depth knowledge of healthcare revenue cycle processes, regulations, and best practices
Bachelor's degree Required Healthcare Administration, Finance, Business Administration, or a related field
10 years Required within payer strategy, contract management, or revenue cycle management
5 years Required Revenue Cycle, payer strategy leadership role

Preferred

Master's degree Preferred Healthcare Administration, Finance, Business Administration, or a related field

Company

Novant Health

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Novant Health is a four-state integrated network of physician clinics, outpatient centers and hospitals.

H1B Sponsorship

Novant Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (9)
2024 (13)
2023 (13)
2022 (10)
2021 (17)
2020 (7)

Funding

Current Stage
Late Stage

Leadership Team

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Betsy Walsh
Senior Vice President Joint Partnerships
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Andrea M. Areskog
Vice President, Corporate Strategy & Development
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Company data provided by crunchbase