About this role

Function as the enterprise authority on payer operational governance, coordinating cross-functional teams to ensure payer compliance, dispute resolution, and performance improvement.
Ensure contract terms are operationalized effectively, payer obligations are enforced, financial targets are met, and performance deficiencies are escalated and resolved.
Lead market-level managed care leadership across California and CAP markets and establish enterprise standards for payer performance oversight, contract enforcement, and managed care operational excellence.
Provide strategic direction through Directors and Senior Managers across multiple states.

Master’s degree in Business Administration, Health Administration, Public Health, or Public Administration
10+ years in managed care, payer operations, or healthcare contracting
7+ years of progressive leadership experience
Experience managing enterprise payer performance portfolios exceeding $1B in net revenue
Experience leading payer dispute resolution and contract enforcement
Experience working in capitated and HMO environments
Membership in HFMA and/or ACHE
Active in CHA and HASC managed care committees

Executive Director, Payer Relations

Key skills