Note: The job is a remote job and is open to candidates in USA. Envision Healthcare is a national medical group focused on delivering high-quality patient care. The Director, Reimbursement Integrity & Payor Analytics leads enterprise reimbursement variance analytics, payor performance insights, and revenue integrity strategy while guiding underpayment recovery, overpayment risk reduction, contract compliance, and analytics team development.
Responsibilities
- Leads the development and execution of reimbursement integrity and payor analytics strategy across the organization
- Oversees analysis of expected vs. actual reimbursement to identify trends, risks, and opportunities
- Establishes frameworks to categorize reimbursement variances, including underpayments, overpayments, configuration defects, operational exceptions, and contract interpretation issues
- Partners with Expected Pay Configuration leadership to support model QA, validation, and pre-go-live testing
- Identifies systemic payor performance and noncompliance trends and translate findings into actionable insights
- Directs development of dashboards, scorecards, and executive reporting to support financial and operational decisionmaking
- Enables prioritization of variance recovery efforts by providing data-driven insights to Revenue Cycle teams
- Drives reduction of false-positive variance volumes through improved analytics, logic refinement, and data quality
- Collaborates with IT and data teams on data architecture, ETL processes, and reporting optimization
- Leads reimbursement intelligence efforts, including contract interpretation support and insights that inform pricing and negotiation strategies
- Builds and leads a high-performing analytics team, fostering technical excellence and strategic thinking
Skills
- To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. The requirements listed below are representative of the knowledge, skills and/or abilities required
- Demonstrated success leading reimbursement analytics, revenue integrity, or healthcare data analytics functions
- Strong expertise in healthcare reimbursement methodologies, payor behavior, and contract structures
- Proven ability to translate complex data into actionable business insights and strategic recommendations
- Experience supporting contract modeling QA, testing, or validation processes
- Strong understanding of data architecture, reporting tools, and analytics methodologies
- Excellent leadership, communication, and cross-functional influence skills
- Ability to identify systemic issues and drive enterprise-level improvements
- Experience collaborating with IT and data engineering teams on analytics and reporting solutions
- High attention to detail and commitment to data accuracy and integrity
- Bachelor's degree required
- 8–12 years of experience in healthcare analytics, reimbursement, or revenue cycle functions
- 4+ years of leadership experience
- Demonstrated success leading analytics, reporting, or reimbursement integrity initiatives
- Progressive experience in data-driven healthcare financial operations
- Advanced degree preferred
Benefits
- Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking, and HSAs
- Qualifying employees are eligible to enroll in benefits from day one
- Paid time off
- 9 observed holidays
- Paid family leave
- A minimum of 20 days and up to 25 days of PTO per calendar year
- Remote workplace arrangement
Company Overview