Metro Vein Centers
Director of Payor Relations
Remote, US · Director
Sponsorship not specifiedDetected 1 day ago
Data VisualizationNegotiationFinancial ModelingRecruitingContract ManagementCadenceResearchLeadershipCommunicationCollaborationProblem Solving
About the role
- Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments.
- Market assignments will be determined based on organizational need and candidate experience.
- The ideal candidate brings deep managed care contracting expertise, a history of leading cross-functional initiatives, and the strategic fluency to thrive in a PE-backed, high-growth specialty practice environment.
Responsibilities
- Lead payor contract negotiations across all commercial, Medicare Advantage, and Medicaid managed care plans within the assigned region, securing favorable rates and terms aligned with organizational benchmarks.
- Maintain a current and comprehensive understanding of the regional payor landscape, including plan relationships, contract status, network participation, fee schedule benchmarks, and market-specific dynamics.
- Develop and maintain financial models, benchmarking analyses, and rate impact assessments to support regional negotiations and executive reporting.
- Develop and execute a regional payor strategy aligned with enterprise growth targets, expansion timelines, and net revenue goals.
- Identify revenue improvement opportunities within the region and develop actionable plans to close gaps, including contract renegotiations, rate corrections, and denial reduction initiatives.
- Assess the payor landscape in prospective expansion markets within or adjacent to the assigned region; identify network gaps, key payor targets, and contracting timelines needed to support de novo clinic launches.
- Lead payor outreach, contract execution, and enrollment coordination for new market entry within the region, working closely with Credentialing and Operations to ensure launch readiness.
- Support enterprise-wide payor strategy initiatives led by the VP of Payor Strategy as needed.
- Establish and maintain SOPs to support consistent execution, new site launches, and market expansions within the assigned regional portfolio.
- Excellent communication and relationship-building skills across payor executives, internal leadership, and cross-functional stakeholders.
Requirements
- Proficiency with contract modeling tools, RCM systems, and analytics platforms (Tableau or equivalent).
Compensation
- This policy applies to all aspects of employment, including recruitment, hiring, promotion, compensation, benefits, and termination.
Benefits
- Build and maintain senior-level relationships with health plan contracting and network management teams operating within the region.
- Own the full contract management and modeling function for the region, including timely updates to reimbursement methodologies, fee schedules, and contract term dates.
- Interpret payor contract terms, reimbursement methodologies, and state-specific requirements, translating them into standardized, scalable operational guidance for consistent execution across markets.
- Monitor payor performance, reimbursement trends, and policy changes across the region; proactively identify revenue leakage, underpayments, and systemic denial patterns before they impact revenue.
- Build and maintain regional dashboards and KPI reporting to track contract profitability, denial trends, payor performance, and reimbursement variances.
- Lead cross-functional communication, education, and process standardization related to payor requirements, contract interpretation, and operational best practices across the region.
- Bachelor's degree in Healthcare Administration, Business, Finance, or a related field; Master's degree (MBA, MHA) strongly preferred.
- 8+ years of progressive experience in managed care contracting, payor relations, or healthcare revenue cycle within a multi-site or multi-state organization.
- Strong analytical skills with the ability to interpret reimbursement terms, model contract scenarios, and translate claims data into actionable strategy.
Company info
- Patients First, Always - Every interaction should make our patients feel valued, heard, and cared for.
- Stronger Together - Teamwork and collaboration drive our success. We lift each other up to deliver the best for our patients.
- A Can-Do Spirit - We meet every challenge with positivity, flexibility, and problem-solving energy.
- Results That Make a Difference - We're driven to improve lives through meaningful, measurable outcomes.
- Commitment to Growth - We invest in our people, fostering advancement and professional development at every level.
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This listing is sourced directly from Metro Vein Centers's careers page and normalized into a canonical job model.