Director of Payer Operations - Remote

Overview

The Director, Payer Operations is a strategic and operational leader responsible for driving enterprise-level initiatives that ensure effective execution, optimization, and compliance of the full payer operations lifecycle.

In Short

• Lead the development and execution of a multi-year strategy for end-to-end payer operations.
• Manage the full lifecycle of provider contracts.
• Identify and lead operational process improvement opportunities.
• Establish and oversee quality assurance processes.
• Collaborate with cross-functional teams to develop integrated solutions.
• Define and monitor KPIs for payer operations.
• Foster a culture of continuous improvement and accountability.
• Build and lead high-performing teams.
• Ensure compliance with regulatory requirements.
• Communicate effectively with senior leaders and stakeholders.

Requirements

• Bachelor’s degree in Healthcare Administration, Business, or related field.
• PMP Certification.
• 10+ years of experience in healthcare operations.
• 6+ years of leadership experience.
• Strong analytical and critical thinking skills.
• Experience with tools like Salesforce and Power BI.
• Excellent verbal and written communication skills.
• Master’s degree preferred.
• Experience with value-based care is a plus.
• Certification in Lean or Six Sigma is preferred.

Benefits

• Medical, Dental, Life, Disability, and Vision coverage.
• 401k savings plan.
• Participation in VillageMD’s benefit platform.
• Opportunities for professional development.
• Work in a compassionate community focused on healthcare improvement.