Job Details

A company is looking for a Director of Provider Reimbursement Strategy to drive sustainable reimbursement models and financial performance across a provider network.Key ResponsibilitiesEstablish and lead reimbursement strategies and payment methodologies across multiple provider types and marketsOversee financial modeling, benchmarking, and payment analysis supporting provider negotiations and network growthEnsure claims payment accuracy through strong analytical processes, contract alignment, and reimbursement governanceQualificationsExtensive experience in provider reimbursement, payment methodology design, and healthcare financial analysisStrong working knowledge of Pennsylvania Medicaid, CMS Medicare, and industry standard payment modelsProven ability to translate complex data into actionable insights for contracting and executive decision makingDemonstrated leadership experience building, mentoring, and retaining high caliber analytical teamsAdvanced analytical, communication, and collaboration skills within matrixed healthcare environments