DIRECTOR OF PAYER STRATEGY AND CONTRACTING

Overview

The Director of Payer Strategy and Contracting is responsible for the development, negotiation, implementation, and management of all payer contracts, following the transition from an externally managed Clinically Integrated Network (CIN) model to an internally governed contracting function. This key leadership role serves as the enterprise lead for payer strategy, contract economics, and payer performance management, ensuring that these efforts are in alignment with the organization's financial goals, clinical strategy, access objectives, and revenue cycle operations.

The Director works closely with the AVP of Revenue Cycle to ensure managed care contracting is integrated with downstream revenue integrity initiatives, denial prevention efforts, utilization management, and strategies for optimizing reimbursement.

Core Responsibilities

Contracting Strategy & Negotiation

• Lead the negotiatio...