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Remote Payer Strategy Jobs in Arizona (NOW HIRING)

... payer strategy, life sciences research, and provider performance solutions. We sit in the middle of ... This position is fully remote, while occasional travel may be required. Primary Responsibilities:

US Remote with preference for candidates located in the Western half of the US and the Midwest ... Develop strategy and lead advocacy efforts with commercial and governmental payers for a defined ...

ESSENTIAL FUNCTIONS • Serve as the primary RCM strategic partner for assigned markets and ... denials through payer-specific analysis and operational collaboration • Partner with cross ...

The role is primarily remote; however, travel to the home office and physician practice locations ... Ensures adherence to federal, state, and payer-specific coding regulations and guidelines.

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Remote Payer Strategy information

What is a remote payer strategy?

A Remote Payer Strategy role involves developing and implementing plans to manage relationships with healthcare payers, such as insurance companies and government programs, from a remote location. Professionals in this position analyze payer trends, negotiate contracts, and ensure that healthcare services are reimbursed efficiently and accurately. They collaborate with internal teams and payers to optimize reimbursement rates and compliance, while working remotely to provide flexibility and broader geographic reach. The position typically requires knowledge of healthcare reimbursement, payer policies, and strong analytical and communication skills.

What are the key skills and qualifications needed to thrive as a remote payer strategy professional, and why are they important?

To excel in Remote Payer Strategy, you need a strong understanding of healthcare reimbursement models, payer contract negotiation, and data analysis, typically supported by a degree in healthcare administration, business, or a related field. Familiarity with payer management systems, claims processing software, and sometimes certifications like Certified Professional in Healthcare Quality (CPHQ) are highly valued. Exceptional communication, strategic thinking, and relationship-building skills set professionals apart in this role. These skills ensure the effective development and execution of reimbursement strategies that optimize revenue and maintain positive payer relationships in a remote environment.

What is the difference between Remote Payer Strategy vs Remote Healthcare Analyst?

AspectRemote Payer StrategyRemote Healthcare Analyst
Required CredentialsBachelor's degree in healthcare, business, or related field; experience in payer or insurance industryBachelor's or master's in healthcare, statistics, or related field; analytical skills
Work EnvironmentFocus on payer strategies, insurance plans, and reimbursement modelsData analysis, reporting, and healthcare data interpretation
Employer & Industry UsageInsurance companies, healthcare payers, healthcare consulting firmsHealthcare providers, research organizations, consulting firms

Remote Payer Strategy professionals focus on developing and implementing strategies related to insurance reimbursement and payer relationships, while Remote Healthcare Analysts analyze healthcare data to inform decision-making. Both roles require healthcare knowledge but differ in their core functions and industry focus.

How does a remote payer strategy professional typically collaborate with cross-functional teams to achieve organizational goals?

As a Remote Payer Strategy professional, you will routinely collaborate with teams such as sales, marketing, medical affairs, and data analytics to develop and execute market access strategies. This collaboration often involves virtual meetings, sharing payer insights, and aligning on tactics to optimize reimbursement and formulary inclusion. Effective communication and adaptability are essential, as you’ll bridge the needs of internal stakeholders with payer expectations, ensuring that the organization’s products gain and maintain favorable access in a dynamic healthcare landscape.
What are popular job titles related to Remote Payer Strategy jobs in Arizona? For Remote Payer Strategy jobs in Arizona, the most frequently searched job titles are:
What cities in Arizona are hiring for Remote Payer Strategy jobs? Cities in Arizona with the most Remote Payer Strategy job openings:

Region Director Care Coordination-Central Region

Dignity Health

Phoenix, AZ • Remote

$69.41 - $103.25/hr

Full-time

Posted 13 days ago


Dignity Health rating

7.9

Company rating: 7.9 out of 10

Based on 283 frontline employees who took The Breakroom Quiz

106th of 887 rated healthcare providers


Job description


Job Summary and Responsibilities

This is a remote position suporting the Central Area Region requiring up to 75% travel

(Central Area includes NV, AZ, NE, IA, WI, MN, ND)

As our Region Director, Care Coordination, you will provide critical leadership in advancing high-quality, patient-centered care. This includes strategic leadership, operational oversight, clinical direction for patient flow, and ensuring alignment with systemwide standards and regulatory requirements for all hospital Care Management functions across your assigned region.
Every day, as a subject matter expert, you will develop comprehensive plans and drive their implementation to deliver tangible results at the region, market, and hospital levels. Collaborating closely with leadership, you will formulate strategies crucial for meeting organizational objectives. This role ensures consistent implementation of system standards, policies, and best practices for patient-centered care coordination, discharge planning, readmission prevention, and length of stay management. You will align hospital teams to system goals, promote interdisciplinary collaboration, and drive operational excellence in care management performance metrics. Furthermore, you must possess a deep understanding of your supported region to adapt to local regulations, having extensive knowledge of local/regional resources. You will champion relationships with state entities, advocate for resources, and foster relationships with community resources. You will also require knowledge of utilization management processes and denial prevention strategies, actively collaborating with relevant System and Regional Directors to reduce preventable denials and strengthen revenue integrity.
To be successful in your role, you will strategically lead and optimize all hospital Care Management functions across the assigned region, ensuring high-quality, patient-centered care, operational excellence, and strict regulatory compliance. You will demonstrate exceptional executive leadership in developing comprehensive plans, driving implementation, fostering interdisciplinary collaboration, and leveraging your deep understanding of local regulations and resources to achieve critical outcomes in patient throughput, discharge planning, and readmission prevention.

  • Strategic Leadership and Operational Excellence: Provides strategic and operational leadership for Care Management functions across all hospitals within the region, ensuring alignment with system priorities and regulatory requirements; Oversees clinical care management operations including progression of care, discharge planning, and social work services, ensuring integration and alignment with system strategies; Leads the implementation and standardization of system policies, procedures, and tools across regional hospitals to promote efficiency, quality, and compliance; Maintains a working knowledge of utilization management workflows, payer requirements, and medical necessity criteria to support accurate level of care determinations and reduce delays; Supports Hospital Directors of Care Management in achieving key performance indicators (LOS, readmissions, discharge efficiency, and patient satisfaction); Monitors and reports regional performance outcomes, identifies variances, and partners with local and system leaders to address opportunities for improvement.
  • Collaborative Partnerships and Stakeholder Engagement: Builds and sustains strategic partnerships with system, regional, market, and hospital leaders; Serves as the primary Care Management liaison for the Region Chief Nursing Officer, promoting coordination of care across acute and post-acute settings; Develops strong working relationships with key stakeholders including regional Chief Medical Officers, Chief Financial Officers, Chief Operating Officers, and Post-Acute leadership; Collaborates with the System and Region Director(s) of Utilization Management to ensure cohesive workflows between care management and utilization review; Applies strategies within daily operations to identify trends and address gaps to facilitate authorizations and reduce preventable denials; Facilitates cross-functional collaboration with departments such as Physician Advisory, Revenue Cycle, Payer Strategy, Compliance, Community Health, Behavioral Health, Ethics, Legal, and Quality; Serves as a proactive advisor and subject matter expert, using data analytics and evidence-based practices to inform decision-making and optimize outcomes; Develops relationships with local/state agencies and associations to optimize resources available to patients; Collaborates with post-acute and community partners to ensure seamless patient transitions and strengthen network integrity; Engages in Clinical Joint Operating Committees (JOCs) with payers to address utilization trends, resolve systemic issues, and drive collaboration on medical necessity and post-acute authorization practices; Partners with Payer Strategy and Revenue Cycle to ensure compliance with payer requirements and maximize reimbursement opportunities under federal, state, and commercial programs; Represents the region on system-level councils and committees where needed, aligning local initiatives with national goals.
  • Strategy Development, Implementation, and Performance Improvement: As a subject matter expert, leads regional execution of system-wide initiatives, such as the various Care Management Playbooks, Shared Governance, and Discharge Optimization programs; Guides hospitals in operationalizing programs that improve progression of care, enhance patient transitions, support throughput, reduce readmissions, reduce avoidable delays, and optimize reimbursement outcomes; Drives operational efficiency and quality through process redesign, standardization, and continuous improvement initiatives;Leverages analytics to inform planning and drive measurable improvements in throughput, patient outcomes, and financial stewardship.
  • Workforce Development, Education, and Talent Management: Champions workforce development by ensuring comprehensive orientation, competency, and continuing education for all regional care management staff. Partners with Human Resources and facility leadership to ensure appropriate staffing models, skill mix, and role optimization to meet patient care needs; Identifies and mentors emerging leaders, developing strong succession pipelines and fostering career growth opportunities; Promotes a culture of accountability, engagement, and recognition, ensuring staff are empowered to deliver compassionate, high-quality care management services.
  • Regulatory Compliance, Ethics, and Organizational Stewardship: Ensures compliance with all applicable federal, state, and local regulations, as well as accreditation and organizational standards governing care management and social work; Maintains audit readiness and serves as a key liaison during internal and external regulatory reviews; Upholds CommonSpirit Health’s Mission, Vision, and Values, ensuring ethical decision-making and adherence to the Code of Conduct; Champions diversity, equity, inclusion, and belonging within the regional care management structure.
  • Additional Responsibilities: Leads or participates in system-wide projects and task forces as assigned; Demonstrates flexibility and resilience in adapting to evolving healthcare environments and organizational priorities.
Job Requirements

Required Education and Experience

  • Masters Other Master's degree 
  • Bachelors Of Nursing
  • Minimum of 10 years in acute care management including 5 years in a leadership role overseeing multiple facilities or a regional structure
  • Proven success in developing and implementing large-scale care management strategies.
  • Registered Nurse license, RN 
  • Accredited Case Manager, ACM
Where You'll Work

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.


Pay Range
$69.41 - $103.25 /hour

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About Dignity Health

Sourced by ZipRecruiter

We welcome the chance to help you feel your best. Excellent, affordable health care, delivered with compassion, is what we stand for. Since our founding in 1986, we've made it our goal to create environments that meet each patient's physical, mental, and spiritual needs. We also believe this healing philosophy promotes the wellbeing of our staff and the places they serve. Dignity Health is made up of more than 60,000 caregivers and staff who deliver excellent care to diverse communities in 21 states. Headquartered in San Francisco, Dignity Health is the fifth largest health system in the nation and the largest hospital provider in California. Through teamwork and innovation, faith and compassion, advocacy and action, we endeavor every day to keep you happy, healthy, and whole.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

San Francisco, CA, US

Year founded

1986

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