Director of Payer Operations

Job Summary

A company is looking for a Director, Payer Operations to lead strategic initiatives in payer operations.

Key Responsibilities

• Develop and execute a multi-year strategy for payer operations and provider enrollment
• Manage the full lifecycle of provider contracts and ensure compliance with regulatory standards
• Identify and implement process improvements to enhance operational efficiency and data integrity

Required Qualifications

• Bachelor's degree in Healthcare Administration, Business, or related field
• PMP Certification
• 10+ years of experience in healthcare operations, focusing on payer contracting or claims operations
• 6+ years of leadership experience managing cross-functional teams
• Experience with tools like Salesforce, Power BI, and contract management platforms