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Market Director Payer Strategy

United States, Englewood Employment contract 60.24 - 79.81 USD / Hour · Job Posted May 04, 2026
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Job Description

This is a remote position. Location preferred for candidate is in the state of TX. Candidate must have experience with healthcare payers and plan in the Texas market. The Market Director, Payer Strategy and Relationships (PSR), is responsible for managed care policies, goals and objectives related to contract language and reimbursement, negotiation strategy, and payer relationships. The Director collects and communicates Market-level insight and strategic knowledge to/from the PSR National Payer teams, the PSR Growth and nnovation team, and other key departments across the enterprise. This position is essential to CommonSpirit Health’s financial performance, and has significant impact on the long-term strategic trajectory of the organization. This position secures optimal fee for service and value-based reimbursement, protects the interests of the owned and/or affiliated hospitals/ancillaries/professional provider entities in contract negotiations, and strengthens CommonSpirit Health’s relationships with payers.

Job Responsibility

  • Responsible for managed care policies, goals and objectives related to contract language and reimbursement, negotiation strategy, and payer relationships
  • Collects and communicates Market-level insight and strategic knowledge to/from the PSR National Payer teams, the PSR Growth and Innovation team, and other key departments
  • Secures optimal fee for service and value-based reimbursement
  • Protects the interests of the owned and/or affiliated hospitals/ancillaries/professional provider entities in contract negotiations
  • Strengthens CommonSpirit Health’s relationships with payers
  • Participates in the development of Market strategy, relationships, and contracts with local and national payers
  • Gathers information and guidance from Region PSR VP, ministry leaders, internal stakeholders, and financial analysis
  • Establishes, builds, and maintains positive, strategic interactions and relationships with payers, employers, providers, and leaders
  • Maintains relationships with National Payer contacts with offices in the Market
  • Maintains appropriate Center of Excellence (COE) Designations
  • Develops and executes communication plans and Payer Negotiation Outlines
  • Makes independent decisions and/or exercises judgment
  • Comprehends and maintains highly detailed information
  • Stays current with emerging payer trends, new reimbursement methodologies, state specific regulatory issues, plan benefits, payer activity, products and delivery channels
  • Supports the strategic objectives of CommonSpirit Health’s IDNs, population health, and care management initiatives
  • Participates in and contributes to CommonSpirit Health’s PSR knowledge base
  • Participates in the dispute resolution and denials processes with local payers if the materiality exceeds $1M
  • Leads and organizes sub-projects necessary to support local and national payer negotiations and growth

Requirements

  • Bachelor’s Degree – equivalent education and experience in payer strategy, managed care or provider network senior level role may be considered in lieu of degree
  • Minimum of five (5) years of experience in healthcare or managed care industry
  • Minimum of four (4) years of leadership experience
  • experience with healthcare payers and plan in the Texas market

What we offer

  • medical
  • prescription drug
  • dental
  • vision plans
  • life insurance
  • paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually)
  • tuition reimbursement
  • retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings

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