Director of Payer and Government Relations

Overview:

Join us in making a meaningful impact in the lives of those we serve.

This is a project based per diem position and can be remote.

The Director will collaborate closely with the management team to ensure alignment with organizational goals and lead special projects that address unique challenges and opportunities in the payer landscape.

Why Care Hospice?

And right now, we're in a period of rapid growth, making it the perfect time to join us on our exciting journey!

Responsibilities:

• Relationship Management: Build and maintain strategic relationships with payers and government agencies to enhance the organization’s position and ensure effective communication regarding hospice services.
• Strategic Leadership: Lead and participate in cross-functional initiatives that address emerging trends, challenges, and opportunities in payer relations and government regulations.
• Advocacy and Representation: Represent the organization in meetings, conferences, and discussions with payers and governmental entities to advocate for policies that support hospice care and reimbursement models.
• Project Management: Oversee special projects related to payer and government relations, ensuring timely and effective execution in alignment with organizational priorities.
• Regulatory Compliance: Stay abreast of changes in healthcare regulations and reimbursement policies, ensuring that the organization remains compliant and well-informed.
• Data Analysis and Reporting: Analyze payer data and trends to identify opportunities for improving reimbursement and service delivery. Prepare reports and recommendations for management.
• Education and Training: Provide guidance and training to internal stakeholders regarding payer and government relations, ensuring understanding of policies and procedures.
• Collaboration: Work closely with clinical, financial, and operational teams to ensure that all aspects of payer and government relations align with overall organizational strategies.

Qualifications:

• Bachelor’s degree in business administration, healthcare management or equivalent work experience(5+ yrs with healthcare payer contracts).
• Strong working familiarity with accounting and financial reporting, using BI systems (ideally Oracle/NetSuite and Tableau).
• 15 years of experience in healthcare payer relations, government affairs, or a related field, preferably within the hospice or home health sector.
• Strong understanding of Medicare, Medicaid, and commercial insurance reimbursement models.
• Strong analytical skills with experience in data-driven decision-making.
• Ability to act with integrity, professionalism, and confidentiality.