Director, Payer Accountability & Reimbursement Performance

Hartford Healthcare • Farmington, CT

1d

About The Position

The Director of Payer Accountability & Reimbursement Performance provides enterprise leadership to ensure Hartford HealthCare receives timely, accurate, and compliant reimbursement for all covered services. The Director is responsible for monitoring payer performance, analyzing systemic denial and underpayment trends, and leading payer accountability and escalation strategies across the organization.The Director works closely across Revenue Cycle Operations, Reporting & Analytics, Managed Care, Finance, Legal, and ITS and Optimization teams to protect revenue integrity, promote operational excellence, and ensure payer accountability to expected reimbursement and timely resolution of issues.

Requirements

• Bachelor’s degree in business, healthcare or a related field is required
• Seven plus years of progressive experience in Revenue Cycle, Managed Care, Payer Reimbursement, or healthcare financial operations
• Five plus years of leadership experience demonstrating the ability to navigate cross-functional initiatives and executive-level partnerships
• Expert knowledge of payer contracts, reimbursement methodologies, and payer policy interpretation
• Strong understanding of hospital and physician billing workflows, claim lifecycle processes, denial patterns, and underpayment reviews
• Demonstrated knowledge of CPT, HCPCS, ICD-10, healthcare documentation standards, billing requirements, and applicable federal and state regulations
• Advanced proficiency with Epic EMR and revenue cycle reporting tools
• Advanced skills in Microsoft Office (Excel, PowerPoint, Word, Outlook, Access) with the ability to create executive-level analyses and presentations
• Exceptional analytical, critical-thinking, and problem-solving skills
• Strong project management and organizational abilities
• Excellent written, verbal, and presentation skills with the ability to communicate complex concepts clearly
• Proven ability to lead across cross-functional stakeholders in a large, matrixed healthcare environment
• Professional integrity, sound judgment, and accountability consistent with Hartford HealthCare values

Responsibilities

• Leads enterprise-wide payer performance management in partnership with Revenue Cycle Operations, Reporting & Analytics, and Managed Care, serving as the primary point of accountability for identifying, prioritizing, and resolving payer issues and escalations
• Owns and leads the enterprise payer accountability and escalation framework serving as the central escalation authority for egregious payer behavior, disputes, and potential legal action. Partnering with Legal to develop and present data-driven documentation supporting payer accountability efforts
• Directs the ongoing analysis of denial reports, accounts receivable aging, and underpayment trends to proactively identify systemic payer risks, reimbursement leakage, and enterprise recovery opportunities
• Provides strategic oversight of payer performance reporting and analytics, ensuring timely, accurate, and actionable insights to support decision-making, escalation prioritization, and executive transparency
• Develops and drives non-transactional, trend-based payer engagement strategies designed to improve payer performance, accelerate issue resolution, and optimize reimbursement outcomes at the enterprise level
• Maintain executive-level expertise in payer policies, contract terms, reimbursement methodologies, and regulatory requirements, assessing enterprise impact and advising leadership on financial, operational, and compliance implications
• Leads enterprise efforts to identify and address claim denial drivers related to contract configuration, documentation, and coverage gaps; direct cross-functional collaboration to implement sustainable resolution and optimization strategies
• Establishes and enforces governance structures, accountability standards, and performance tracking mechanisms
• Champions compliant reimbursement, ethical revenue integrity practices, and continuous improvement while influencing outcomes across a complex, matrixed organization

Benefits

• competitive benefits program designed to ensure work/life balance

What This Job Offers

• Job Type: Full-time
• Career Level: Director