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Payers Direct Jobs in Virginia (NOW HIRING)

Revive Bhs Llc

Executive Director

Henrico, VA · On-site

$80K - $120K/yr

The Executive Director oversees program performance, fiscal sustainability, quality improvement ... Community Payer Relations ● Maintain relationships with Virginia Medicaid MCO representatives ...

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General Child Neurologist (MD/DO)

Fairfax, VA · On-site

$200 - $300/hr

Payer Credentialing: Ability to successfully complete the credentialing process by third-party payors and enroll as a CMS Medicare/Medicaid payer. * Medical Staff Credentialing: Successful completion ...

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What is the difference between Payers Direct vs Payers Account Manager?

AspectPayers DirectPayers Account Manager
CredentialsTypically requires insurance or healthcare-related certifications, such as CPC or CPC-HOften requires similar certifications, with additional experience in client management
Work EnvironmentPrimarily office-based, handling claims processing and payer communicationsOffice setting with client interaction, focusing on account management and relationship building
Employer & IndustryHealth insurance companies, healthcare providers

While both roles involve working with payers in the healthcare industry, Payers Direct focuses on claims processing and payer communication, whereas Payers Account Managers emphasize maintaining client relationships and account oversight. Understanding these differences helps in choosing the right career path or job search focus within healthcare insurance roles.

What is Payers Direct?

Payers Direct is a company that provides healthcare payment solutions, often involving claims processing, billing, and reimbursement services for insurance providers and healthcare providers. Employees in roles at Payers Direct typically need knowledge of healthcare billing systems, insurance policies, and relevant compliance standards.
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Infographic showing various Payers Direct job openings in Virginia as of June 2026, with employment types broken down into 100% Part Time. Highlights an 100% In-person job distribution.

Executive Director

Revive Bhs Llc

Henrico, VA • On-site

$80K - $120K/yr

Full-time

Medical, PTO

Re-posted yesterday

Job description

Benefits:
  • Health insurance
  • Paid time off
  • Training & development

Position Summary
The Executive Director provides strategic, operational, financial, and regulatory leadership for a
licensed outpatient substance use disorder (SUD) treatment program in the Commonwealth of
Virginia.
This position is responsible for ensuring compliance with Virginia DBHDS regulations, DMAS
ARTS requirements, Virginia Medicaid MCO contracts, and applicable federal standards. The
Executive Director oversees program performance, fiscal sustainability, quality improvement
initiatives, staff development, and community engagement.
Core Responsibilities
Regulatory Compliance Oversight
● Ensure ongoing compliance with Virginia DBHDS licensing regulations (12VAC35-105
and applicable chapters).
● Ensure compliance with DMAS ARTS requirements.
● Oversee Medicaid billing compliance and documentation standards.
● Maintain compliance with Virginia Medicaid MCO contract requirements, including
credentialing, authorization, and reporting expectations.
● Lead preparation for DBHDS inspections, Medicaid audits, and MCO reviews.
● Ensure corrective action plans are implemented when necessary.
Operational Leadership
● Oversee daily operations of outpatient services, including IOP, OP, and other ARTS
levels of care as applicable.
● Ensure clinical workflows align with DMAS documentation and medical necessity
standards.
● Monitor performance metrics, census, productivity, and service utilization.
● Develop and enforce policies and procedures consistent with regulatory expectations.
Financial Management
● Develop and manage the annual operating budget.
● Ensure appropriate billing and coding practices are followed.
● Oversee financial reporting and cost containment strategies.
Clinical Program Oversight
● Ensure implementation of evidence-based substance use treatment services.
● Oversee Clinical Director and Medical Director functions.
● Monitor treatment outcomes and quality improvement initiatives.
● Ensure ARTS multidimensional assessments, treatment planning, and documentation
standards are consistently met.
Staff Leadership Development
● Recruit, supervise, and evaluate management and clinical staff.
● Ensure staff meet credentialing requirements under DMAS and DBHDS.
● Promote a recovery-oriented and compliance-driven organizational culture.
● Implement ongoing staff training related to regulatory and payer requirements.
Community Payer Relations
● Maintain relationships with Virginia Medicaid MCO representatives.
● Coordinate with referral sources, healthcare systems, and community partners in the
Greater Richmond area.
● Represent the organization in regulatory, payer, and stakeholder meetings.
Required Qualifications
● Master’s degree or higher in healthcare administration, public health, social work,
counseling, or related field.
● Minimum five (5) years of leadership experience in substance use treatment.
● Demonstrated experience with Virginia DMAS ARTS services and Medicaid billing.
● Working knowledge of Virginia Medicaid MCO operations and authorization processes.
● Experience with Virginia DBHDS licensing and inspection processes.
● Strong understanding of outpatient substance use disorder service delivery models.
● Proven financial and operational management experience.
Preferred Qualifications
● Licensed behavioral health professional (LPC, LCSW, LMFT, etc.).
● Experience with Joint Commission or CARF accreditation.
● Prior experience opening or scaling an outpatient ARTS program in Virginia.