Director, Payor Relations

Position Summary:

We are seeking a dynamic and strategic Director, Payor Relations to lead and strengthen partnerships with commercial, government, and managed care payors. In this high-impact leadership role, you will drive pay or strategy, oversee contract negotiations, and optimize reimbursement performances to support the organization's long-term financial health and patient access initiatives. This individual will also play a key role in shaping innovative payor partnerships, resolving complex issues, monitoring contract performance, and ensuring compliance with evolving regulatory requirements, all while advancing UTHealth Houston's mission and growth objectives.

Position Key Accountabilities:

• Payor Strategy & Relationship Management Develops and maintains strong, collaborative relationships with commercial, government, and managed care payors. Serves as the primary point of contact for payor negotiations, escalations, and ongoing relationship management. Represents the organization in payor meetings, joint operating committees, and strategic discussions.
• Contracting & Negotiation Leads payor contract strategy, including negotiation, implementation, amendment, and renewal of payor agreements. Collaborates with legal, finance, compliance, and clinical leadership to ensure contracts align with organizational objectives and regulatory requirements. Analyzes contract terms to optimize reimbursement, mitigate risk, and support value-based payment models.
• Financial & Performance Oversight Monitors payor performance, reimbursement trends, denial rates, and compliance with contract terms. Partners with revenue cycle, finance, and analytics teams to evaluate financial impact and identify opportunities for improvement. Develops and tracks key performance indicators (KPIs) related to payor relationships and contract outcomes.
• Issue Resolution & Compliance Oversees resolution of complex payor issues, including underpayments, disputes, and operational challenges. Ensures compliance with federal and state regulations, accreditation standards, and organizational policies related to payor activity. Supports audits, reviews, and regulatory inquiries involving payor contracts and reimbursement.
• Leadership & Collaboration Provides leadership and guidance to payor relations and contracting staff, as applicable. Works closely with executive leadership, clinical leaders, and operational partners to educate on payor contracts and align payor strategies with care delivery and growth initiatives. Prepares reports, analyses, and recommendations for senior leadership.
• Strategic Initiatives Supports organizational initiatives related to network expansion, new service lines, population health, and value-based care. Evaluates market trends, payor policies, and regulatory changes to inform strategic planning and decision making. Participates in systemwide projects and cross functional committees as assigned.
• Manages Human Resources activities for direct reports in regards to: recruiting and selection; hiring and termination, training, development, mentoring, counseling, performance evaluations, and salary planning.
• Responsible for the design, execution and effectiveness of a system of internal controls which provides reasonable assurance that operations are effective and efficient, assets are safeguarded; financial information is reliable and compliant with applicable laws, regulations, policies and procedures.
• Performs other duties as assigned.

Certification/Skills:

• None

Minimum Education:

Bachelor's Degree in healthcare administration, business administration, finance, or a related field required Master's Degree in healthcare administration, business administration, or related field preferred

Minimum Experience:

7 years of progressively responsible experience in payor relations, managed care contracting, or healthcare finance required

Physical Requirements:

Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.

Security Sensitive:

This position is a security-sensitive position pursuant to Texas Education Code §51.215 and Texas Government Code §411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code §117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. §791.4.

Residency Requirement:

Employees must permanently reside and work in the State of Texas.