Director of Payor Relations

The Director of Payor Relations directs and leads the Payor Relations and Managed Care Contracting efforts on behalf of UI Health Care, including University of Iowa Health Care Medical Center, University of Iowa Health Care Medical Center Downtown, Carver College of Medicine UI Physicians, UI College of Dentistry Dental Service Plan, UI Diagnostic Labs and other divisions of the University of Iowa Health Care. This executive role steers overarching payor strategies, drives complex contract negotiations, manages specialized regional/federal agreements, and serves as the senior point of escalation for operational payor friction, systematic underpayments, and net collection yield optimization.

Position Responsibilities:

Payor 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.

• Serves as the primary executive contact for payor counterparts, establishing and leading Joint Operating Committees (JOCs) and corporate performance reviews.

• Defines, develops, and directs the implementation strategies for all payor relationships.

• Directs and executes medical service agreements with the VA Medical Center, ensuring all contracts are consistently reviewed for appropriate pricing within federal rules and conditions. Partners closely with University of Iowa Physicians (UIP) leadership to ensure the MSAs align seamlessly with the clinical and educational goals of the faculty practice plan.

Managed Care Contracting Leadership

• 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.

• Monitors and interprets market intelligence, directing and evaluating proposal analyses.

• Leads the entire negotiation process, representing the organization to the contracting party, managing internal communication, and making recommendations to senior leadership.

• Directs the development, assessment, implementation, and maintenance of contract language, working closely with legal counsel to establish firm institutional guardrails and templates

• Negotiates and implements new contracts and renegotiates and maintains existing contracts to ensure that optimal contribution to margin is achieved

Contract Performance Monitoring

• Monitors existing contracts to determine financial and administrative performance.

Internal Contract Consultation

• Provides consultation and support to clinical and administrative departments for contractual and relationship issues.

• 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.

Contracting and Reimbursement Strategy

• Formulates innovative reimbursement methodologies across the enterprise, including traditional fee-for-service arrangements (DRG, APC, case rates) and specialized models.

• Directs the design and integration of value-based contracting strategies, focusing explicitly on effectively layering value-based performance incentives, shared savings, and quality metrics directly on top of established fee-for-service frameworks.

• Prepares reports, analyses, and recommendations for senior leadership.

• Directs contracting for complex transplant programs, overseeing global rate package modeling. 

Reimbursement Methodology Development

• Determines the optimal reimbursement methodology for contracts for facility and physicians.

• Tracks and analyzes industry trends, payor policy updates, and state/federal governmental reimbursement changes; forecasts the long-term operational and financial impact on the enterprise portfolio and directly applies these insights to optimize contract terms, mitigate regulatory risk, and secure favorable reimbursement structures.

Financial Analysis and Planning

• Monitors existing payor portfolios to continuously determine financial, administrative, and clinical volume performance.

• Directs the financial analysis of contract performance, oversees the contract management software infrastructure, and produces periodic reports for executive leadership

Revenue Optimization

• Serves as the primary institutional escalation point to actively resolve chronic, patterned payor issues, including systematic denials, slow payments, medical necessity disputes, and contract compliance failures.

• Identifies, tracks, and addresses root-cause operational inefficiencies that result in poor payment yield or administrative underpayments.

• Collaborates with Patient Financial Services, Health Information Management (HIM), Utilization Management, and Revenue Integrity to translate contract terms into actionable front- and back-end rules, validating that contract terms load accurately into the health system's billing and decision-support systems.

• Utilizes historical denial and payor behavior trends to establish strategic leverage for subsequent contract renegotiations. 

Leadership and Training

• Establishes and maintains standards of collaborative interaction among peers and employees that is characterized by respect, honesty and service; assures that all unit members are held to similar standards and ethics; constructively manages conflict.

• Manages the talents, strengths and behaviors of each individual in a work group, while providing each employee with the opportunity to contribute to the goals of the unit.

• Inspires and motivates others to high performance by exercising strong stewardship of University resources, setting expectations, measuring success through individual performance evaluations, and driving organizational results.

• Mentors staff

• Assists the Assistant Vice President/ CFO, UI Health Care on major projects.

Required:

• Master’s degree in Accounting, Finance, Business Administration, Healthcare Administration, or an equivalent combination of education and experience.

• 7 years of progressive experience in health care payor relations management or managed care contracting is required.

• Excellent written and verbal communication skills are required.

• Proficiency in computer software applications

• Ability to solve problems in a professional manner

• Demonstrated experience working effectively in a welcoming and respectful workplace environment

Desired:

• Ability to manage and mentor a team.

• Prove ability to reallocate resources as needed to meet goals and objectives

• Ability to work in a team environment

• Strong customer service orientation.

• Ability to work independently and take initiative.

• Ability to lead change processes within a changing environment.

• Knowledge of UI and UI Health Care policies and procedures.

Application Process: To be considered, applicants must upload a cover letter and resume (under the submission of relevant materials) that clearly address how they meet the listed required and desired qualifications of this position. Job openings are posted for a minimum of 7 calendar days. Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and credential/education verification.

•  Up to 5 professional references will be requested at a later step in the recruitment process. For questions, contact Sharon Walther at sharon-walther@uiowa.edu.

This position is not eligible for University sponsorship for employment authorization now or in the future.

This position is eligible for hybrid work within Iowa and will require a work arrangement form to be completed upon the start of your employment. Per policy, work arrangements will be reviewed annually, and must comply with the remote work program and related policies and employee travel policy when working at a remote location.