[Hiring] Director of Payor Relations @Metro Vein Centers

Role Description

The Director of Payor Relations is a senior individual contributor responsible for owning all payor relations and payor strategy activity across an assigned regional market portfolio within Metro Vein Centers’ multi-state, multi-TIN network. This individual is the single point of accountability for every payor relationship, contract, negotiation, and strategic initiative within their region—operating with a high degree of autonomy while staying aligned with enterprise objectives.

• Own the full lifecycle of payor contract management within their region: market research, building relationships with payors, interpreting contract terms, maintaining fee schedules, driving renegotiations, resolving payor issues, and translating complex reimbursement requirements into clear operational guidance for Revenue Cycle, Finance, Credentialing, and Operations.
• Assess the regional payor landscape, identify revenue opportunities and risks, and develop the forward-looking plan to grow and protect net revenue across all active and expansion markets as assigned.

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field; Master’s degree (MBA, MHA) strongly preferred.
• 8+ years of progressive experience in managed care contracting, payor relations, or healthcare revenue cycle within a multi-site or multi-state organization.
• Demonstrated history of managing or leading teams, functions, or cross-functional initiatives in a prior role.
• In-depth knowledge of commercial payor structures, Medicare Advantage, and Medicaid managed care variations across multiple states.
• Strong analytical skills with the ability to interpret reimbursement terms, model contract scenarios, and translate claims data into actionable strategy.
• Proven track record of negotiating and executing complex payor contracts with measurable, positive revenue impact.
• Proficiency with contract modeling tools, RCM systems, and analytics platforms (Tableau or equivalent).
• Excellent communication and relationship-building skills across payor executives, internal leadership, and cross-functional stakeholders.
• Demonstrated ability to manage multiple complex projects across regions with competing priorities and minimal day-to-day oversight.
• Experience in a PE-backed, multi-state healthcare organization, MSO, specialty medical group, or ASC environment.

Requirements

• Serve as the single point of accountability for all payor relationships, contracts, negotiations, and strategic initiatives across an assigned regional portfolio.
• Lead payor contract negotiations across all commercial, Medicare Advantage, and Medicaid managed care plans within the assigned region.
• Maintain a current and comprehensive understanding of the regional payor landscape.
• Build and maintain senior-level relationships with health plan contracting and network management teams.
• Ensure all regional payor contracts, fee schedules, amendments, and provider enrollment statuses are accurate, compliant, and up to date.
• Serve as the regional escalation point for complex payor issues.
• Own the full contract management and modeling function for the region.
• Interpret payor contract terms, reimbursement methodologies, and state-specific requirements.
• Monitor payor performance, reimbursement trends, and policy changes across the region.
• Conduct regular market reviews across current payor relationships.
• Develop and maintain financial models, benchmarking analyses, and rate impact assessments.
• Develop and execute a regional payor strategy aligned with enterprise growth targets.
• Build and maintain regional dashboards and KPI reporting.
• Identify revenue improvement opportunities within the region.
• Stay current on CMS policy, state-specific regulatory changes, and commercial payor developments.
• Assess the payor landscape in prospective expansion markets.
• Lead payor outreach, contract execution, and enrollment coordination for new market entry.
• Support enterprise-wide payor strategy initiatives as needed.
• Lead cross-functional communication, education, and process standardization.
• Establish and maintain SOPs to support consistent execution.
• Partner with Credentialing and Enrollment to ensure seamless provider participation.
• Communicate regional payor performance, risks, and strategic updates to the VP of Payor Strategy.

Benefits

• Healthy legs. Happier lives.
• Exceptional care begins with an exceptional experience.
• Commitment to compassion, expertise, and trust.
• Values that guide everything we do: Patients First, Always; Stronger Together; A Can-Do Spirit; Results That Make a Difference; Commitment to Growth.