Director of Revenue and Payer Operations

Boulder Care

104d • $145,000 - $160,000

About The Position

We’re looking for a strategic, detail-oriented, and highly analytical Director of Revenue and Payer Operations to serve as a key internal leader in our growth efforts. You’ll play a critical role in structuring frameworks for new market entry, scaling go-to-market processes, optimizing contract performance, and driving revenue growth. You’ll report directly to the Head of Growth Partnerships and work closely with the Associate Director of Value-Based Contracting, Partnerships Manager, and Directors of RCM, Product, and Data. This is a hands-on role that blends financial analysis, operational oversight, and strategic guidance. You'll be a great fit for this role If you have deep healthcare finance and contracting expertise, thrive in a data-driven environment, and can move seamlessly between strategy and execution.

Requirements

• Minimum 5 years in healthcare contracting, strategy, consulting, or payer/provider partnerships
• Expertise in fee schedules, coding, and reimbursement analysis
• Strong understanding of Medicaid programs and value-based care models
• Proven track record managing complex projects and delivering insights to senior leadership
• Analytical, detail-oriented, and an excellent communicator, with the ability to move between high-level strategy and hands-on execution

Responsibilities

• Manage operational tracking for the payer contracting function, including reimbursement terms, pipeline reporting, and forecasting
• Conduct fee schedule analyses, assess financial impact, and advise on coding/reimbursement alignment to support performance under value-based contracts
• Build and maintain financial models to inform rate negotiations and track contract performance
• Partner with Finance and Operations to ensure smooth contract implementation
• Support large or complex contract opportunities, ensuring cross-functional alignment
• Research and analyze Medicaid policy, market dynamics, and competitor positioning to inform market entry strategy
• Develop strategic frameworks for growth, including FFS optimization and value-based contracting readiness
• Advise leadership on opportunities and risks tied to payer strategy
• Provide modeling, research, and contracting insights to support business development initiatives
• Monitor contract performance against metrics and targets
• Track payments, quality measures, and incentive programs, identifying gaps and opportunities
• Partner with Finance and Ops to ensure reporting accuracy and compliance
• Develop dashboards and reporting to guide business decisions and optimize payer strategy
• Deliver regular KPI reporting to leadership, highlighting risks and opportunities
• Act as the central business partner for internal teams (Data, Product, Finance, Clinical) on payer strategy and operations
• Create and maintain source-of-truth documents and dashboards
• Take on high-priority special projects to advance payer-facing growth

Benefits

• Contribution to meaningful, life-saving work!
• Comprehensive medical, dental, vision, and short-term disability benefits designed to take care of our employees and their families
• Mental Health Services via Regence, Doctors on Demand, and EAP for continuous care
• 4 weeks of vacation accrued per calendar year with a tenured increase to 5 weeks at 2 years of employment
• Sick leave accrued at 1 hr for every 30 hrs paid
• 9 Paid Holidays per year
• 12 weeks of 100% paid parental leave for the birth or adoption of a child (after 6 months of employment)
• 401(k) retirement savings
• Remote friendly with hardware provided to complete your work duties

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Bachelor's degree
• Number of Employees: 51-100 employees