Us
Senior Director, Healthcare Payer
Pittsburgh - Moon Township · Director
Sponsorship not specifiedDetected 31 days ago
ExpressComplianceNegotiationPerformance ManagementHIPAALeadershipCommunicationCollaboration
About the role
- The Senior Director, Healthcare Payer oversees the growth full lifecycle of payer, provider, and network contracting for a DME healthcare organization.
- The role requires deep knowledge of Medicare, Medicaid, commercial insurance, and DME‑specific reimbursement policies.
Responsibilities
- Develop and implement a comprehensive contracting strategy for payer and provider agreements.
- Lead negotiation, renewal, and execution of contracts across Medicare, Medicaid, Medicaid MCOs, Medicare Advantage, commercial payers, ACOs, IDNs, and other DME funding channels.
- Establish and maintain strong working relationships with payer partners, network managers, and governmental bodies.
- Partner with Legal, Compliance, and Revenue Cycle teams to mitigate risk and ensure aligned processes.
Requirements
- Strong knowledge of federal/state regulatory requirements for DME suppliers.
Benefits
- Conduct financial and strategic analysis of proposed contract terms to ensure strong reimbursement and sustainable margins.
- Collaborate with Revenue Cycle, Billing & Collections, Reimbursement, Clinical, and Finance teams to ensure contract terms are operationally achievable.
- Support reimbursement programs, appeals strategy, and payer performance improvement initiatives.
- DME & Healthcare Policy Expertise
Company info
- The Senior Director, Healthcare Payer drives contract strategy leads negotiations, analysis of value of contracts, maintains payer relationships, and ensures the company remains competitive, compliant, and positioned for long‑term success.
Equal opportunity
- Employer/AA Women/Minorities/Veterans/Disabled
- We believe diversity not only enriches our workplace culture, but also gives us a strategic advantage.
- Working with people from a variety of backgrounds and perspectives helps us all become better communicators, better problem solvers, and better human beings.
- Our differences make us stronger.
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