Payer Strategy Manager Jobs in Wisconsin (NOW HIRING)

Remote Office Austin, TX 78701

Work Arrangement:
Remote: Open to applicants in the United States, excluding CA, IL, ND, NY, OH, WA, and WY.
Hybrid: For individuals within 60 miles of Albuquerque, in-office presence is required Tuesday through Thursday.

Presbyterian Healthcare Services (PHS) seeks a strategic, influential executive to serve as Vice President of Payer Strategy for the Presbyterian Delivery System (PDS). This high‑impact role sits at the intersection of finance, strategy, and payer relations—responsible for shaping how the organization delivers sustainable growth in an increasingly complex reimbursement landscape. The leader will define and execute a system‑wide payor contracting and revenue optimization strategy across a diverse and integrated delivery network. The Vice President will lead negotiations, advance value‑based care models, and drive net revenue performance across hospitals, medical group, ambulatory services, and specialty service lines.

• Define and execute a system‑wide payer contracting strategy aligned with growth, market positioning, and financial performance goals.
• Develop and implement a comprehensive managed care strategic and tactical plan with clear performance targets.
• Identify and advance innovative reimbursement models, including value‑based and risk‑based arrangements.
• Lead and oversee negotiations of commercial and governmental managed care agreements to secure optimal reimbursement.
• Serve as authorized signatory for managed care contracts.
• Continuously evaluate contract performance and lead renegotiation or restructuring efforts as needed.
• Drive initiatives to enhance net revenue yield through contract optimization, recovery efforts, and performance monitoring.
• Analyze reimbursement trends and implement targeted interventions to address risk areas and improve outcomes.
• Contribute to financial forecasting, budgeting, and capital planning processes.
• Establish and oversee performance monitoring frameworks and reporting to track managed care outcomes.
• Ensure robust internal controls, compliance with regulatory requirements, and alignment with enterprise financial systems.
• Lead system configuration and optimization of contract management tools and reporting capabilities.
• Lead, mentor, and develop a high‑performing managed care and contracting team.
• Foster cross‑functional collaboration across Finance, Revenue Cycle, Operations, Strategy, and Physician Integration.
• Serve as a trusted advisor to executive leadership, providing insights and recommendations on payor strategy and risk.
• Build and sustain strong relationships with managed care organizations and key external stakeholders.
• Represent PHS in payer negotiations, regulatory discussions, and industry forums.
• Collaborate across the enterprise to strengthen market position and grow accretive service lines.

• Strengthen Contract Performance: Improve reimbursement yield and contract effectiveness across the system.
• Advance Value‑Based Strategy: Expand and optimize value‑based agreements with measurable financial and quality outcomes.
• Enhance Revenue Integrity: Identify and execute net revenue improvement and recovery initiatives.
• Elevate Payer Relationships: Build strategic, durable relationships with key payor partners.
• Drive Organizational Alignment: Establish clear accountability, metrics, and governance for managed care performance.

• Master’s degree in Business, Healthcare Administration, Finance, or related field.
• Minimum of 15 years of progressive experience in payer strategy, managed care contracting, or healthcare finance.
• Demonstrated success in senior leadership roles within integrated health systems or complex healthcare organizations.
• Deep knowledge of reimbursement methodologies, including fee‑for‑service, value‑based care, risk‑sharing, and capitation models.
• Strong understanding of healthcare policy, regulatory environments, and evolving payment models.

• Strategic Negotiator: Proven ability to lead high‑stakes payer negotiations and secure favorable outcomes.
• Financial Acumen: Advanced analytical and financial modeling capabilities with strong business judgment.
• Enterprise Leader: Experience operating within complex, matrixed healthcare systems.
• Influential Communicator: Ability to translate complex financial concepts into actionable insights for executive and clinical leaders.
• Relationship Builder: Skilled at developing trust‑based relationships with internal stakeholders and external partners.
• Change Agent: Demonstrated success leading transformation and driving results in dynamic, evolving environments.
• High Emotional Intelligence: Navigates conflict, complexity, and ambiguity with diplomacy and professionalism.

• Competitive salaries
• Full medical, dental and vision insurance
• Flexible spending accounts (FSAs)
• Free wellness programs
• Paid time off (PTO)
• Retirement plans, including matching employer contributions
• Continuing education and career development opportunities
• Life insurance and short/long term disability programs

AA/EOE/VET/DISABLED. PHS is a drug‑free and tobacco‑free employer with smoke‑free campuses.