The Director is responsible for monitoring payer performance, analyzing systemic denial and underpayment trends, and leading payer accountability and escalation strategies across the organization.The ...
The Director is responsible for monitoring payer performance, analyzing systemic denial and underpayment trends, and leading payer accountability and escalation strategies across the organization.The ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Quick apply
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Through digital listening and patient analytics, we are able to understand our customers' needs and strive to provide solutions to meet them. The Associate Director, US Pharma Payer Marketing ...
Through digital listening and patient analytics, we are able to understand our customers' needs and strive to provide solutions to meet them. The Associate Director, US Pharma Payer Marketing ...
Role Summary Pfirzer is seeking an experienced Senior Director to lead market access initiatives ... payer analytics, and payer market trends * Lead Medicare and Medicaid strategy and government ...
Role Summary Pfirzer is seeking an experienced Senior Director to lead market access initiatives ... payer analytics, and payer market trends * Lead Medicare and Medicaid strategy and government ...
Through digital listening and patient analytics, we are able to understand our customers' needs and strive to provide solutions to meet them. The Associate Director, US Pharma Payer Marketing ...
Through digital listening and patient analytics, we are able to understand our customers' needs and strive to provide solutions to meet them. The Associate Director, US Pharma Payer Marketing ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Quick apply
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Quick apply
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Through digital listening and patient analytics, we are able to understand our customers' needs and strive to provide solutions to meet them. The Associate Director, US Pharma Payer Marketing ...
Through digital listening and patient analytics, we are able to understand our customers' needs and strive to provide solutions to meet them. The Associate Director, US Pharma Payer Marketing ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Quick apply
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Quick apply
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Through digital listening and patient analytics, we are able to understand our customers' needs and strive to provide solutions to meet them. The Associate Director, US Pharma Payer Marketing ...
Through digital listening and patient analytics, we are able to understand our customers' needs and strive to provide solutions to meet them. The Associate Director, US Pharma Payer Marketing ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer ... On a quarterly basis, lead direct reports on the creation and the updating of contract performance ...
Director Payer Analysis information
What is a director of payer analysis?
A Director of Payer Analysis is a senior healthcare management professional responsible for analyzing and optimizing relationships between healthcare providers and insurance payers. They use data to evaluate reimbursement rates, contract terms, and payer performance to maximize financial outcomes for their organization. This role often involves collaborating with financial, operational, and clinical teams to identify opportunities for revenue improvement and cost savings. Directors of Payer Analysis also help develop strategies for contract negotiations and ensure compliance with regulatory requirements.
What does a typical week look like for a director of payer analysis in a healthcare organization?
A typical week for a Director of Payer Analysis involves leading a team to analyze contracts, reimbursement trends, and payer performance data. The role requires frequent collaboration with finance, revenue cycle, and managed care teams to provide strategic insights and support contract negotiations. Directors often prepare and present detailed reports to senior leadership, highlighting opportunities for revenue optimization and risk mitigation. Balancing analytical tasks with cross-departmental meetings and ensuring data integrity are common challenges faced in this position.
What are the key skills and qualifications needed to thrive as a director of payer analysis, and why are they important?
To thrive as a Director of Payer Analysis, you need expertise in healthcare reimbursement, contract negotiation, data analytics, and a relevant degree such as healthcare administration or finance. Familiarity with financial modeling tools, claims management systems, and data analysis software like SQL or Tableau is typically required. Strong leadership, analytical thinking, and effective communication skills help in managing teams and collaborating with payers and providers. These skills are crucial for optimizing payer contracts, maximizing revenue, and ensuring strategic decision-making in a complex healthcare landscape.
What is the difference between Director Payer Analysis vs Payer Analyst?
| Aspect | Director Payer Analysis | Payer Analyst |
|---|---|---|
| Credentials | Bachelor's degree, often advanced certifications in healthcare or finance | Bachelor's degree, relevant certifications preferred |
| Work Environment | Leadership roles, strategic planning, team management | Data analysis, reporting, supporting payer contract negotiations |
| Industry Usage | Healthcare organizations, insurance companies, large healthcare systems | Healthcare providers, insurance companies, consulting firms |
The main difference between a Director Payer Analysis and a Payer Analyst lies in scope and responsibility. The Director oversees strategic initiatives, manages teams, and makes high-level decisions, while the Payer Analyst focuses on data analysis, reporting, and supporting payer-related activities. Both roles require healthcare industry knowledge, but the director position involves more leadership and strategic planning.
How to become director of payer analysis?
To become a Director of Payer Analysis, candidates typically need a bachelor's degree in healthcare administration, finance, or a related field, along with extensive experience in payer contract analysis, revenue cycle management, or healthcare finance. Advanced skills in data analysis, familiarity with healthcare billing systems, and leadership experience are also important. Earning certifications such as Certified Healthcare Financial Professional (CHFP) can enhance prospects for advancement.
What does a director payer analysis do?
A director of payer analysis oversees the evaluation of insurance reimbursement policies and payer contracts to optimize revenue and ensure compliance. They analyze payer data, identify trends, and develop strategies to improve reimbursement processes, often using tools like Excel or specialized healthcare analytics software. This role requires strong analytical skills and knowledge of healthcare billing and coding practices.
What states have the most Director Payer Analysis jobs?
States with the most job openings for Director Payer Analysis jobs include:
What are popular job titles related to Director Payer Analysis jobs?
For Director Payer Analysis jobs, the most frequently searched job titles are:
Director, Payer Accountability & Reimbursement Performance
Farmington, CT • On-site
Hartford HealthCare at Home
• Health Care and Social Assistance • 201 - 500 employees201 - 500 employees
Full-time
Re-posted 21 days ago
Job description
Work where every moment matters.
Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.
Hartford HealthCare is transforming healthcare across Connecticut and beyond-enhancing access, affordability, health equity, and excellence. Spanning 500 locations across 185 towns and cities, our comprehensive care-delivery system is built to serve every community, every day. From world-class hospitals-including two tertiary-level teaching hospitals, an acute-care community teaching hospital, an acute-care hospital and trauma center, and three community hospitals-to an expansive network of behavioral health services, multispecialty physician groups, urgent and virtual care, surgery centers, home care, senior care, rehabilitation, and mobile neighborhood health programs, Hartford HealthCare is there when and where it matters most. We touch the lives of nearly 28,000 people every single day, delivering unparalleled care through our unique Institute Model-bringing together leading experts in neuroscience, cancer, digestive health, heart and vascular care, orthopedics, and urology & kidney health to provide a unified, high standard of care at the most affordable cost.
Position Summary:
The Director of Payer Accountability & Reimbursement Performance provides enterprise leadership to ensure Hartford HealthCare receives timely, accurate, and compliant reimbursement for all covered services. The Director is responsible for monitoring payer performance, analyzing systemic denial and underpayment trends, and leading payer accountability and escalation strategies across the organization.The Director works closely across Revenue Cycle Operations, Reporting & Analytics, Managed Care, Finance, Legal, and ITS and Optimization teams to protect revenue integrity, promote operational excellence, and ensure payer accountability to expected reimbursement and timely resolution of issues.
Key Accountabilities:
Qualifications:
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge - helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.
Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.
Hartford HealthCare is transforming healthcare across Connecticut and beyond-enhancing access, affordability, health equity, and excellence. Spanning 500 locations across 185 towns and cities, our comprehensive care-delivery system is built to serve every community, every day. From world-class hospitals-including two tertiary-level teaching hospitals, an acute-care community teaching hospital, an acute-care hospital and trauma center, and three community hospitals-to an expansive network of behavioral health services, multispecialty physician groups, urgent and virtual care, surgery centers, home care, senior care, rehabilitation, and mobile neighborhood health programs, Hartford HealthCare is there when and where it matters most. We touch the lives of nearly 28,000 people every single day, delivering unparalleled care through our unique Institute Model-bringing together leading experts in neuroscience, cancer, digestive health, heart and vascular care, orthopedics, and urology & kidney health to provide a unified, high standard of care at the most affordable cost.
Position Summary:
The Director of Payer Accountability & Reimbursement Performance provides enterprise leadership to ensure Hartford HealthCare receives timely, accurate, and compliant reimbursement for all covered services. The Director is responsible for monitoring payer performance, analyzing systemic denial and underpayment trends, and leading payer accountability and escalation strategies across the organization.The Director works closely across Revenue Cycle Operations, Reporting & Analytics, Managed Care, Finance, Legal, and ITS and Optimization teams to protect revenue integrity, promote operational excellence, and ensure payer accountability to expected reimbursement and timely resolution of issues.
Key Accountabilities:
- Leads enterprise-wide payer performance management in partnership with Revenue Cycle Operations, Reporting & Analytics, and Managed Care, serving as the primary point of accountability for identifying, prioritizing, and resolving payer issues and escalations
- Owns and leads the enterprise payer accountability and escalation framework serving as the central escalation authority for egregious payer behavior, disputes, and potential legal action. Partnering with Legal to develop and present data-driven documentation supporting payer accountability efforts
- Directs the ongoing analysis of denial reports, accounts receivable aging, and underpayment trends to proactively identify systemic payer risks, reimbursement leakage, and enterprise recovery opportunities
- Provides strategic oversight of payer performance reporting and analytics, ensuring timely, accurate, and actionable insights to support decision-making, escalation prioritization, and executive transparency
- Develops and drives non-transactional, trend-based payer engagement strategies designed to improve payer performance, accelerate issue resolution, and optimize reimbursement outcomes at the enterprise level
- Maintain executive-level expertise in payer policies, contract terms, reimbursement methodologies, and regulatory requirements, assessing enterprise impact and advising leadership on financial, operational, and compliance implications
- Leads enterprise efforts to identify and address claim denial drivers related to contract configuration, documentation, and coverage gaps; direct cross-functional collaboration to implement sustainable resolution and optimization strategies
- Establishes and enforces governance structures, accountability standards, and performance tracking mechanisms
- Champions compliant reimbursement, ethical revenue integrity practices, and continuous improvement while influencing outcomes across a complex, matrixed organization
Qualifications:
- Bachelor's degree in business, healthcare or a related field is required
- Seven plus years of progressive experience in Revenue Cycle, Managed Care, Payer Reimbursement, or healthcare financial operations
- Five plus years of leadership experience demonstrating the ability to navigate cross-functional initiatives and executive-level partnerships
- Expert knowledge of payer contracts, reimbursement methodologies, and payer policy interpretation
- Strong understanding of hospital and physician billing workflows, claim lifecycle processes, denial patterns, and underpayment reviews
- Demonstrated knowledge of CPT, HCPCS, ICD-10, healthcare documentation standards, billing requirements, and applicable federal and state regulations
- Advanced proficiency with Epic EMR and revenue cycle reporting tools
- Advanced skills in Microsoft Office (Excel, PowerPoint, Word, Outlook, Access) with the ability to create executive-level analyses and presentations
- Exceptional analytical, critical-thinking, and problem-solving skills
- Strong project management and organizational abilities
- Excellent written, verbal, and presentation skills with the ability to communicate complex concepts clearly
- Proven ability to lead across cross-functional stakeholders in a large, matrixed healthcare environment
- Professional integrity, sound judgment, and accountability consistent with Hartford HealthCare values
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge - helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.
About Hartford HealthCare at Home
Sourced by ZipRecruiter
Hartford HealthCare at Home, based in Wethersfield, Connecticut, US, is a premier provider in the healthcare industry, specifically in home-based care services. Their official website can be accessed at hartfordhealthcareathome.org. They offer a wide range of services including nursing, physical therapy, occupational therapy, speech therapy, social work, and home health aid. The company was established with the mission to enhance the capability of people to achieve optimal health and wellbeing through its home care services. They maintain a patient-centric approach and belief in making a real difference in people's lives. As an integral part of Hartford HealthCare, they share the vision to be “most trusted for personalized coordinated care”.
Industry
Health care and social assistance
Company size
201 - 500 Employees
Headquarters location
Wethersfield, CT, US