Director, Revenue Cycle Payer Performance

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: + We serve faithfully by doing what's right with a joyful heart. + We never settle by constantly striving for better. + We are in it together by supporting one another and those we serve. + We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: + Immediate eligibility for health and welfare benefits + 401 (k) savings plan with dollar-for-dollar match up to 5% + Tuition Reimbursement + PTO accrual beginning Day 1Note: Benefits may vary based upon position type and/or level Job Summary Under the direction of the Vice President, Revenue Cycle Support Services, the Director, Payer Performance leads Revenue Cycleu2019s strategic efforts to identify and correct issues related to commercial underpayments and denials. This role serves as a critical liaison between Revenue Cycle leadership and Managed Care leadership to support and streamline payer communications. The Director will also be responsible for developing tools to monitor reimbursement, track revenue opportunities, and ensure ongoing adherenceu2014by both BSWH and commercial payersu2014to implemented solutions. This position does not have direct reports but functions within a matrixed organizational structure, collaborating closely with teams across Revenue Cycle, Managed Care, Finance, and Operations. Essential Functions of the Role u2022 Develop effective communication channels across the Revenue Cycle to identify commercial payer trends, underpayments, and opportunities for BSWH revenue improvement u2022 Track denials and avoidable write-offs (AWOs) across all regions; improve efficiency of regional workgroups by coordinating scalable, system-wide solutions u2022 Drive resolution of all payer-related revenue opportunities by coordinating across internal stakeholders and third-party vendors u2022 Serve as the central point of contact for Revenue Cycle, Finance, and Operations regarding commercial payer issues and outstanding concerns u2022 Manage projects related to revenue optimization and denial mitigation, ensuring timely delivery and adherence to budget constraints u2022 Support Revenue Cycle leadership with strategic planning and prioritization of key commercial reimbursement projects based on financial impact u2022 Represent Revenue Cycleu2019s interests in contract negotiations; maintain a strong working knowledge of managed care contract language and operational implications u2022 Provide actionable feedback to inform BSWH payer scorecards and performance evaluations u2022 Assist the Managed Care department in preparing for regular payer meetings, including surfacing operational issues and identifying opportunities for improved performance u2022 Develop and maintain process workflows for communicating and implementing contract updates that affect Revenue Cycle functions u2022 Partner with the Revenue Analytics team and Managed Care to assess financial impacts of commercial contract changes and ensure alignment with reimbursement expectations u2022 Co-develop reporting and analytics tools to proactively monitor reimbursement trends, identify underpayments, and uncover additional revenue opportunitiesu2014including denial patterns u2022 Leverage automation opportunities and system capabilities to streamline internal practices and optimize revenue u2022 Stay informed on emerging technologies and tools related to revenue optimization, contract compliance, and denial management, present viable opportunities to senior leadership u2022 Utilize a broad range of technology platformsu2014including Epic and other revenue cycle, analytics, and reporting toolsu2014to support data-driven decision-making u2022 Operate effectively in a matrixed organization, collaborating across teams without direct authority to influence performance and outcomes u2022 Coordinate with stakeholders across departments and systems to standardize workflows and drive systemic improvements in payer performance Key Success Factors u2022 Strong written and verbal communication skills u2022 Ability to manage a demanding workload and demonstrate resiliency in high-stakes or rapidly changing situations u2022 Proven ability to build strong relationships across all levels of the organization, including executives, physicians, and frontline staff u2022 Demonstrated ability to lead cross-functional initiatives and influence without direct authority in a matrixed environment u2022 Strategic mindset with the ability to align operational execution with broader organizational goals u2022 Strong understanding of revenue cycle processes, systems, and technologies u2022 Significant experience with Epic EHR, including Hospital Billing, Professional Billing, and Reporting u2022 Strong attention to detail, with the ability to synthesize complex information into clear, concise summaries u2022 Strong data interpretation and reporting skills, including the ability to translate data into actionable insights u2022 Excellent presentation skills, with the ability to develop and deliver executive-level communications and deliverables u2022 Ability to use real-world examples to support strategic negotiations with business partners u2022 Ability to interpret and operationalize commercial contract language u2022 Understanding of payer policies, healthcare reimbursement regulations, and compliance requirements related to commercial payers u2022 Experience leading or contributing to large-scale process improvement or change management initiatives within the revenue cycle Belonging Statement We believe that all people should feel welcomed, valued, and supported. Qualifications u2022 Education - Bachelor's or 4 years of work experience above the minimum qualification. Bacheloru2019s degree very highly preferred; degree in Business, Finance, Healthcare Administration, or related field preferred. Masteru2019s degree (e.g., MBA, MHA) is a plus. u2022 Experience- Minimum of 5 years of progressive experience in healthcare revenue cycle, payer relations, or managed care contracting. Experience in a matrixed or integrated healthcare delivery system strongly preferred. Preferred Qualifications u2022 Familiarity with Epic EHR (Hospital and Professional Billing modules) u2022 Experience working cross-functionally with Managed Care, Finance, and Revenue Analytics teams u2022 Certification(s) such as CHFP, CRCR, or equivalent preferred but not requiredAs a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

Created: 2026-03-07