Payer Strategy Jobs in Florida (NOW HIRING)

Location Address:

Remote Office Austin, TX 78701

Summary:

Presbyterian Healthcare Services (PHS) seeks a strategic, influential executive to serve as Vice President of Payer Strategy for the Presbyterian Delivery System (PDS). This is a high-impact role at the intersection of finance, strategy, and payer relations-responsible for shaping how the organization delivers sustainable growth in an increasingly complex reimbursement landscape.
This 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.
This is an ideal role for a seasoned healthcare executive who combines deep reimbursement expertise, strong financial acumen, and executive presence-with the ability to influence both internal stakeholders and external payer partners in a rapidly evolving healthcare environment.
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.

Job Description:

Strategic Payor Leadership

• 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

Contracting & Negotiation Excellence

• 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

Revenue Optimization & Financial Performance

• 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

Operational Oversight & Governance

• 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

Organizational Leadership & Collaboration

• 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

Relationship Management & Market Influence

• 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

Success Measures

Within the first 12-24 months, the Vice President will:

• 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

Additional Job Description:

Education

• Required: Master's degree in Business, Healthcare Administration, Finance, or related field

Knowledge & Work Experience

• Experience: Minimum of 15 years of progressive experience in payer strategy, managed care contracting, or healthcare finance

• Leadership: Demonstrated success in senior leadership roles within integrated health systems or complex healthcare organizations

• Reimbursement Expertise: Deep knowledge of reimbursement methodologies, including fee-for-service, value-based care, risk-sharing, and capitation models

• Industry Acumen: Strong understanding of healthcare policy, regulatory environments, and evolving payment models

Core Competencies

• 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

Benefits
Benefits are effective day-one (for .45 FTE and above) and include:

• 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

About Us
Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system ofnine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.
Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans.
We are part of New Mexico's history-and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.

About New Mexico
New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great.
Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC.
New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.