Corporate Director of Payer Contracting & Strategy Nutex Health is seeking a highly strategic and dynamic Corporate Director of Payer Contracting & Strategy to lead our organization’s efforts in developing and executing comprehensive payer contracting initiatives. This pivotal leadership role involves overseeing the negotiation, management, and optimization of payer agreements to enhance revenue streams and ensure alignment with organizational goals. The ideal candidate will possess a strong background in healthcare or insurance contracting, strategic planning, and business development, with proven management and leadership capabilities. This position offers an opportunity to influence organizational growth through innovative contract strategies, process improvements, and effective team supervision.
RESPONSIBILITIES
Strategic Leadership:
- Develop and lead the hospital system’s payor strategy, ensuring alignment with enterprise goals for growth, quality, and financial stability.
- Identify market and policy trends affecting payor-provider relationships and advise the executive team on strategic implications.
- Build and maintain a culture of collaboration and accountability within the revenue cycle and payor contracting teams.
Payor Contracting and Negotiation:
- Oversee negotiation, execution, and management of all payor contracts—including commercial, Medicare Advantage, Medicaid Managed Care, and employer direct contracts.
- Drive innovation in contract structure, including bundled payments, shared savings, and other value-based reimbursement models.
- Partner with legal and compliance teams to ensure contract terms meet regulatory and organizational requirements.
- Develop escalation and resolution processes for payor disputes and denials in collaboration with revenue cycle leadership.
Financial and Performance Management:
- Partner with Finance to develop budget, payor performance dashboards, monitor contract performance, and forecast reimbursement trends.
- Analyze payor mix, contract yield, and payment integrity to identify revenue optimization opportunities.
- Support strategic pricing initiatives and ensure payor rates align with organizational cost structure and service line strategy.
Value-Based Care & Population Health:
- Collaborate with the Population Health Services Organization and Clinical Operations teams to align payor contracts with care management and quality improvement initiatives.
- Develop and oversee value-based arrangements that reward quality, efficiency, and outcomes across the continuum of care.
- Monitor contract performance and risk-based metrics to ensure positive financial and clinical results.
Stakeholder & Relationship Management:
- Serve as the primary executive liaison to payor partners, cultivating relationships that drive long-term collaboration.
- Represent the organization in payor forums, policy discussions, and industry coalitions to advocate for equitable reimbursement and care delivery reform.
- Provide strategic counsel to hospital and physician leaders on payor trends and their operational impact.
- Regularly presents to Executive Leadership Team
REQUIREMENTS
Experience:
• Minimum 10 years of progressively responsible experience in healthcare payor contracting, reimbursement, or strategy—preferably within a multi-hospital system.
- Minimum 10 years of progressively responsible experience in healthcare payor contracting, reimbursement, or strategy—preferably within a multi-hospital system.
- Proven record of success leading complex payor negotiations and implementing value-based contracts.
- Demonstrated understanding of healthcare finance, hospital operations, and regulatory reimbursement frameworks (Medicare, Medicaid, and commercial payors).
- Deep understanding of managed care principles, payor-provider dynamics, and hospital reimbursement methodologies (DRG, APC, per diem, capitation, etc.). Strong financial and analytical acumen, with the ability to interpret data and translate insights into strategic action.
- Exceptional negotiation, relationship-building, and executive communication skills. Must communicate and interact effectively at the C-suite level.
- Ability to lead cross-functional teams and drive organizational alignment around payor strategy.
Education:
- A Master’s Degree in Health Care, Public Health or Business Administration is preferred; Bachelor’s Degree in Business, Health Administration, Finance, or related field required.
- 10+ years related experience in a managed care payer environment, with a minimum of 5 years management or leadership experience in value-based care.
BENEFITS
• Competitive salary commensurate with experience
- Competitive salary commensurate with experience
- Medical, Dental, Vision plans; zero-premium plans available for employee-only
- HSA, FSA, and Dependent Care Account
- 401K with company match
- Employee Assistance Program
- Voluntary plans such as Critical Illness and Life
- Employee Stock Purchase Program
- Company paid STD, LTD, Life Insurance
- PTO, Paid holidays