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Vice President Payer Relations Jobs (NOW HIRING)

US Eye

Vice President, Payer Relations

FL · Remote

The Vice President of Payer Relations is responsible for developing and leading the organization's payer strategy across its ophthalmology practices, ambulatory surgery centers, and affiliated ...

New

The Emily Program

VP of Payer Relations

Roseville, MN · On-site

$180K - $210K/yr

Position Overview The Vice President of Payer Relations is a senior executive responsible for defining and leading The Emily Program's payer strategy across commercial, Medicaid/ Medicare, and other ...

Accanto Health

VP of Payer Relations

Roseville, MN · On-site

$180K - $210K/yr

Position Overview The Vice President of Payer Relations is a senior executive responsible for defining and leading The Emily Program's payer strategy across commercial, Medicaid/ Medicare, and other ...

Phsorg

... 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 ...

Ellipsis Health, Inc

VP Payer Sales

San Francisco, CA · On-site

$180K - $220K/yr

Reporting to the Chief Growth Officer, Payer & PBM, the VP Payer Sales a high profile role responsible for driving growth of Ellipsis Health's Payer and PBM segments. This individual will seek new ...

0090 Presbyterian System Services

WI · On-site

$150 - $180/hr

... 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 ...

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Vice President Payer Relations information

What does a vice president payer relations do?

A Vice President of Payer Relations is responsible for developing and managing relationships with health insurance companies and other payers to negotiate contracts, ensure favorable reimbursement rates, and resolve issues related to claims or coverage. They lead a team that works closely with both external payers and internal departments such as finance, billing, and compliance. Their work is crucial in optimizing revenue cycles, maintaining profitability, and ensuring patients have access to covered services. This role requires a deep understanding of healthcare regulations, payer policies, and the overall healthcare reimbursement landscape.

What are the key skills and qualifications needed to thrive as a vice president payer relations?

To excel as a Vice President of Payer Relations, you need deep knowledge of healthcare reimbursement, contract negotiation, and regulatory compliance, typically backed by an advanced degree in healthcare administration, business, or a related field. Familiarity with contract management systems, healthcare analytics platforms, and payer-provider data exchange technologies is crucial. Outstanding leadership, relationship-building, and strategic communication skills distinguish top performers in this role. These competencies are vital for securing favorable payer agreements, ensuring organizational profitability, and maintaining strong industry partnerships.

How does a vice president payer relations typically collaborate with internal teams to optimize contract negotiations with insurance providers?

A Vice President of Payer Relations works closely with finance, legal, clinical, and business development teams to ensure that contract negotiations with insurance providers align with the organization's strategic and financial goals. This involves regular cross-departmental meetings to review data, discuss reimbursement strategies, and assess the impact of proposed terms on service delivery. By fostering open communication and leveraging the expertise of various departments, the VP ensures contracts are both competitive and compliant, ultimately supporting the organization's growth and operational efficiency.

What is the difference between Vice President Payer Relations vs Director Payer Relations?

AspectVice President Payer RelationsDirector Payer Relations
ResponsibilitiesStrategic leadership, high-level negotiations, policy developmentOversees payer account management, contract negotiations, team supervision
Required CredentialsBachelor's degree, extensive experience, leadership skillsBachelor's degree, relevant experience, strong negotiation skills
Work EnvironmentExecutive-level meetings, strategic planning sessionsTeam management, client meetings, operational oversight

The Vice President Payer Relations focuses on strategic leadership and high-level negotiations with payers, while the Director Payer Relations manages day-to-day payer accounts and supervises teams. Both roles require relevant experience and strong negotiation skills, but the VP role involves broader strategic responsibilities and leadership within the organization.

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What are the most commonly searched types of Payer Relations jobs?

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Vice President Payer Relations jobs near you
Infographic showing various Vice President Payer Relations job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, 1% Temporary, and 1% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution.

Vice President, Payer Relations

US Eye

FL • Remote

Full-time

Posted yesterday

New

US Eye rating

5.7

Company rating: 5.7 out of 10

Based on 15 frontline employees who took The Breakroom Quiz

Job description

JOB SUMMARY:
The Vice President of Payer Relations is responsible for developing and leading the organization’s payer strategy across its ophthalmology practices, ambulatory surgery centers, and affiliated services. This executive role oversees payer contracting, reimbursement analysis, network participation, relationship management, and issue resolution to support sustainable growth and appropriate payment for the services provided.
The Vice President of Payer Relations serves as the organization’s primary strategic liaison with commercial health plans, Medicare Advantage plans, managed Medicaid plans, and other payer partners. Working closely with executive leadership, Finance, Revenue Cycle, Operations, Credentialing, and physician leaders, this role translates complex payer dynamics into clear business strategies and practical action plans.
ESSENTIAL JOB FUNCTIONS (other duties as required):Adherence to applicable laws, regulations, and contractual obligations. Follows the principles of the Compliance Program as well as the US Eye Code of Conduct.
Payer Strategy and Executive Leadership
  • Develop and execute a comprehensive payer-relations strategy that aligns with the organization’s clinical, operational, and financial goals.
  • Advise executive leadership on payer trends, reimbursement risks, contracting opportunities, and market developments.
  • Establish priorities for payer negotiations based on reimbursement performance, patient access, geographic expansion, service-line growth, and organizational needs.
  • Evaluate the financial and operational impact of payer policies, contract terms, and reimbursement changes.
  • Support strategic planning for new practice locations, physician groups, ambulatory surgery centers, and other affiliated services.
  • Represent the organization in executive-level discussions with health plans and other payer partners.
Contract Negotiation and Management
  • Lead negotiations for commercial, Medicare Advantage, managed Medicaid, and other applicable payer agreements.
  • Evaluate contract terms, reimbursement methodologies, fee schedules, payment policies, network requirements, and administrative provisions.
  • Partner with Finance and Revenue Cycle leadership to model the financial impact of proposed agreements and contract amendments.
  • Ensure contracts support appropriate reimbursement for ophthalmology services, including office visits, diagnostic testing, procedures, surgical services, and specialty care.
  • Maintain a centralized process for monitoring contract terms, renewal dates, amendments, notice periods, and key obligations.
  • Identify opportunities to improve reimbursement, strengthen contract language, and reduce administrative burden.
  • Coordinate with legal counsel as appropriate when reviewing or negotiating agreements.
Payer Relationship Management
  • Build and maintain productive relationships with payer executives, provider-relations representatives, contracting teams, and medical-management leaders.
  • Serve as an escalation point for high-impact payer issues affecting reimbursement, patient access, claims processing, prior authorization, or provider participation.
  • Conduct regular payer meetings and business reviews to address performance, policy changes, operational concerns, and opportunities for collaboration.
  • Promote timely communication between payers and internal stakeholders.
  • Develop strategies to strengthen payer partnerships while protecting the organization’s financial and operational interests.
Reimbursement and Financial Performance
  • Partner with Finance and Revenue Cycle teams to monitor reimbursement trends, payer performance, denials, payment accuracy, and contract compliance.
  • Analyze reimbursement by payer, service line, provider, location, and procedure category to identify opportunities and risks.
  • Support the development of reporting tools and dashboards that provide visibility into payer performance.
  • Identify underpayments, payment variances, and systemic reimbursement issues requiring payer escalation or corrective action.
  • Develop strategies to improve net revenue, reduce payment delays, and address unfavorable reimbursement trends.
  • Assess the potential impact of proposed payer policy changes and recommend appropriate organizational responses.
Network Participation and Patient Access
  • Evaluate payer network-participation opportunities based on patient access, market presence, reimbursement, administrative requirements, and strategic value.
  • Support the organization’s participation in payer networks that align with growth plans and patient-care objectives.
  • Monitor network status and help address issues that may affect patient access or provider directory accuracy.
  • Partner with Credentialing and Provider Enrollment teams to promote timely payer enrollment and accurate participation records.
  • Coordinate payer-relations activities related to physician onboarding, practice acquisitions, new locations, and service expansions.
Cross-Functional Collaboration
  • Collaborate with Revenue Cycle, Finance, Operations, Credentialing, Compliance, Legal, Clinical Leadership, and Information Technology teams.
  • Translate contract requirements and payer policies into clear guidance for operational teams.
  • Partner with practice leaders to identify payer-related barriers affecting scheduling, patient access, authorizations, claims, or collections.
  • Provide education and updates to leadership regarding material payer changes and emerging issues.
  • Support due diligence and integration planning for organizational growth initiatives, including acquisitions and new market entry.
Regulatory and Industry Awareness
  • Maintain knowledge of healthcare reimbursement trends, payer policies, managed-care practices, and applicable regulatory developments.
  • Monitor changes that may affect ophthalmology reimbursement, ambulatory surgery center payments, prior authorization requirements, and patient access.
  • Partner with Compliance and legal counsel to support adherence to applicable laws, regulations, contractual obligations, and organizational policies.
  • Maintain appropriate confidentiality and professional discretion when handling sensitive business information.
Team Leadership
  • Lead, develop, and support payer-relations team members and other assigned staff.
  • Establish goals, performance measures, workflows, and accountability standards.
  • Foster a collaborative culture focused on data-informed decision-making, timely follow-up, and continuous improvement.
  • Promote effective communication across departments and ensure payer-related initiatives remain aligned with organizational priorities.
Reasonable accommodation may be given to individuals with disabilities to perform the essential functions.
COMPETENCIES:
  • Demonstrated ability to follow oral and written instructions.
  • Demonstrated knowledge of material, methods, instruments and equipment.
  • Demonstrated ability to read, write and perform mathematical calculations.
  • Ability to multi-task, work in a fast-paced environment and manage time accordingly to meet deadlines and requirements of the organization.
  • Advanced knowledge of payer contracting, managed-care principles, reimbursement structures, and healthcare financial analysis.
  • Strong negotiation skills with the ability to build productive relationships while advocating for organizational priorities.
  • Ability to evaluate complex data and translate findings into practical business recommendations.
  • Strong executive presence and the ability to communicate effectively with physicians, senior leaders, payer representatives, and cross-functional teams.
  • Excellent judgment, analytical thinking, and problem-solving skills.
  • Ability to manage multiple priorities, deadlines, and negotiations in a fast-paced healthcare environment.
  • Strong written, verbal, and presentation skills.
  • High level of professionalism, discretion, and integrity when handling confidential financial and contractual information.
  • Proficiency with Microsoft Office applications and the ability to work with contract-management, reporting, and analytics tools.
SUPERVISORY RESPONSIBILITIES:
The VP of Payer Relations carries out supervisory responsibilities in accordance with the organization’s policies and applicable laws. Responsibilities include interviewing, hiring and training employees, planning, assigning and directing work, appraising performance, rewarding and disciplining employees and addressing staff complaints and resolving problems.
WORK ENVIRONMENT:
This position operates primarily in a professional office environment with regular interaction with executive leaders, physicians, operational teams, and external payer representatives. The role may require travel to practice locations, ambulatory surgery centers, payer meetings, and industry events
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Demonstrated ability to do excessive walking, standing, bending and stooping. While performing the duties of this job, the employee is frequently required to stand, sit, use hands to handle or feel objects, tools or control, reach with hands and arms and talk or hear. The employee is occasionally required to climb or balance, kneel and crouch.
The employee may be required to lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.
POSITION TYPE AND EXPECTED HOURS OF WORK:
This is a full-time salaried position. Days and hours are Monday through Friday 8:00 A.M. – 5:00 P.M. Salaried staff may be required to work beyond their set schedule due to business needs and expectations.
TRAVEL:
Travel is required. REQUIRED EDUCATION AND EXPERIENCE:
  • Bachelor’s degree in healthcare administration, business administration, finance, economics, or a related field required.
  • Eight or more years of progressive experience in payer relations, managed-care contracting, reimbursement strategy, healthcare finance, revenue cycle, or a related field.
·Demonstrated ability to interpret complex contract language, fee schedules, reimbursement methodologies, and payer policies.PREFERRED EDUCATION AND EXPERIENCE:
  • Master’s degree in business administration, healthcare administration, or a related field preferred.
  • Five or more years of leadership experience preferred.
  • Experience negotiating payer contracts for a multi-location medical practice, specialty physician group, ambulatory surgery center organization, or healthcare system strongly preferred.
  • Experience with ophthalmology, optometry, surgical services, or specialty healthcare reimbursement is highly desirable.
OTHER DUTIES:
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

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