Director, Payer Performance

Overview

Opportunity based in Fresno, Ca.

Opportunities for you! 

• Recognized by Newsweek as one of America's Greatest Workplaces for 2026 
• Eligible for annual incentive program, progressive sign-on incentive and comprehensive relocation package 
• Community University leadership training courses 
• Tuition reimbursement, education programs and scholarships 
• Vacation time accrues from Day 1 at the maximum allowable accrual rate 
• Free money toward retirement with a 403(b) and matching contributions 
• Great on-demand dining options, plus free parking and EV charging ordering 

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. 

Responsibilities

As Director, Payer Performance, you’re committed to the positive retention and engagement of your team members. You recognize effective communication as a top priority. You identify as an agent of change, solving organizational challenges through insight and inquiry. Exploring new avenues to help your teams and the organization succeed is central to your work. You’ll stand by decisions in the interest of Community; the popular and the unpopular.  As the Director of Payer Performance, you will lead the strategy, analysis, and optimization of payer reimbursement and contract performance to drive revenue integrity and growth across the health system. You'll serve as a key partner to Finance, Managed Care, Legal, Compliance, and executive leadership, translating complex payer, contractual, financial, and operational data into actionable insights and strategies.  In this role, you'll oversee payer performance analytics, reimbursement variance reviews, denial management, contract modeling, and revenue leakage identification, while leading efforts to resolve underpayments, payment discrepancies, and other payer-related issues. Additionally, you will support contract negotiations and renewal strategies, ensure compliance with regulatory requirements, and develop a high-performing team focused on enhancing payer accountability and improving overall financial performance.

 

Qualifications

Education

• Bachelor’s Degree in healthcare administration, Business Administration, Finance, Accounting, or related field required

• Master’s Degree in healthcare administration, Business Administration, Finance, Accounting, or related field preferred

 

Experience

• Five (5) years of healthcare revenue cycle or payer-related experience required

• Three (3) or more years of management or leadership experience in a healthcare or payer environment required

• Experience developing performance dashboards and executive reporting required

• Experience with revenue cycle analytics, business intelligence, or data visualization platforms required

Preferred Experience

• Ten (10) or more years of healthcare revenue cycle or payer-related experience preferred

• Experience working within an integrated health system or multi-hospital environment preferred

• Experience with payer contract management or managed care operations preferred

• Prior payer-side experience strongly preferred

• Strong understanding of:  

  • Hospital reimbursement methodologies 

  • DRGs and payment structures 

  • Insurance contracts and contract analysis 

  • Revenue cycle operations 

  • Regulatory and compliance requirements related to payer reimbursement 

• Epic experience is preferred, though Cerner experience is acceptable. 
• Ability to translate complex financial and operational data into executive-level presentations and actionable recommendations. 

 

Licenses and Certifications

• HFMA - Healthcare Financial Management Association Certification preferred

Disclaimers

• Pay ranges listed are an estimate and subject to change.• If any bonuses are noted, they are only applicable to external hires meeting criteria.