Director of Payor Contracting & Strategy

Title: Director of Payor Contracting & Strategy

• Job category: Revenue Cycle
• Requisition number: DIREC011464
• Full-time
• Locations
• EM Operations
• Colorado Springs, CO 80920, USA

Job Description:

Envision Radiology is seeking a full time Director of Payor Contracting & Strategy!

Full time, Monday-Friday | Pay range: $129,960 - $162,450

Summary/Objective

The Director of Payor Contracting and Strategy is responsible for leading all aspects of payor negotiations, managed care strategy, and reimbursement optimization for Envision Radiology. This position develops and executes comprehensive contracting strategies that enhance reimbursement, strengthen payor relationships, and support the organization's long-term growth objectives. The Director collaborates cross-functionally with Revenue Cycle, Credentialing, Finance, and Operations to ensure contract performance aligns with operational capabilities and financial goals.

Essential Functions

1.  Develops and executes comprehensive payor contracting strategies aligned with company financial and operational objectives.
2.  Leads negotiations with commercial and governmental payors to secure favorable reimbursement terms.
3.  Conducts financial modeling and scenario analysis to evaluate contract proposals and renewal terms.
4.  Analyzes contract language, fee schedules, reimbursement methodologies, and performance metrics to ensure optimal outcomes.
5.  Maintains working knowledge of Medicare and alternative reimbursement methodologies and ensures alignment across commercial contracts.
6.  Partners closely with Revenue Cycle Management to monitor contract performance, identify underpayments, and drive resolution of payer issues.
7.  Collaborates with Credentialing and Operations teams to ensure seamless implementation of new and amended contracts.
8.  Provides executive-level reporting and insights using Tableau, Excel, PowerPoint, and other analytical tools.
9.  Identifies opportunities for process improvement across people, systems, and technology. 10. Creates and maintains guides, SOPs, announcements, and other documentation for impacted departments.
10.  Performs other duties as assigned.

Competencies

•  Ethical Conduct.
•  Thoroughness.
•  Collaboration Skills.
•  Time Management.
•  Organization Skills.
•  Project Management.
•  Personal Effectiveness/Credibility.
•  Negotiation.

Supervisory Responsibility

This position is responsible for assisting with performance management of hiring of the employees within the department.

Work Environment

This job operates remotely and must adhere to work at home requirements. There may be travel required for Leadership training, onsite center visit, and/or team collaboration.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to use hands and fingers to handle, feel or operate objects, tools or controls, and reach with hands and arms. The employee is frequently required to talk and hear.

Travel

Quarterly travel may be required.

Job Qualifications

Job Qualifications/Experience:

• Five plus years of relevant payor contracting experience, including and not limited to: Revenue Cycle Management, Payor Contracting, and Medical Billing.
• Working knowledge and understanding of Medicare reimbursement methodologies
• Strong analytical and problem-solving skills across people, process, and technology
• Proficiency in Excel, PowerPoint, Word, Smartsheet, Adobe or similar solutions
• Demonstrated ability to work collaboratively across multiple functions (Revenue Cycle, Credentialing, Payor Contracting)
• Outstanding organizational and communication skills (verbal and written)
• Highly motivated self-starter and team player
• Comfortable navigating ambiguity and driving innovation in a fast-growing environment
• Attention to detail is a must
• Must be organized, with the ability to track many different items at once

Education/Certifications:

• Bachelor’s degree or equivalent

Additional Eligibility Qualifications

None required for this position.

Compliance

Adheres to Envision’s Code of Conduct and Compliance Policies and attends annual Compliance training as set forth by the Company.

Company Benefits

The following benefit programs are available to eligible employees. Benefits eligibility is dependent on a variety of factors, including employee classification.

• Health Benefits: Medical/Dental/Vision/Life Insurance
• Company Matched 401k Plan
• Employee Stock Ownership Plan
• Paid Time Off + Paid Holidays
• Employee Assistance Program

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

OSHA Exposure Rating: 1

It is reasonably anticipated NO employees in this job classification will have occupational exposure to blood and other potentially infectious body fluids.

Envision Radiology is an equal opportunity employer (M/F/D/V). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state, or local law.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.