Community Health System

Regional hospital network delivering medical care

Director Payer Performance

Corporate Finance & FP&AUpdated on Nov 5

Full-timeFresno, CA, USANo salary listed

About the Job

Requirements

A bachelor's degree in healthcare administration, business administration, finance, accounting, or a related field is required.
Five years of healthcare revenue cycle or payer-related experience are required.
Three or more years of management or leadership experience in a healthcare or payer environment are required.
Experience developing performance dashboards and executive reporting is required.
Experience with revenue cycle analytics, business intelligence, or data visualization platforms is required.

Responsibilities

Lead the strategy, analysis, and optimization of payer reimbursement and contract performance to drive revenue integrity and growth across the health system.
Partner with Finance, Managed Care, Legal, Compliance, and executive leadership, translating complex payer, contractual, financial, and operational data into actionable insights and strategies.
Oversee payer performance analytics, reimbursement variance reviews, denial management, contract modeling, and revenue leakage identification.
Lead efforts to resolve underpayments, payment discrepancies, and other payer-related issues.
Support contract negotiations and renewal strategies.
Ensure compliance with regulatory requirements.
Develop a high-performing team focused on enhancing payer accountability and improving overall financial performance.
Promote positive retention and engagement of team members, prioritize effective communication, and address organizational challenges through insight and inquiry.

Desired Qualifications

A master's degree in healthcare administration, business administration, finance, accounting, or a related field is preferred.
Ten or more years of healthcare revenue cycle or payer-related experience are preferred.
Experience working within an integrated health system or multi-hospital environment is preferred.
Experience with payer contract management or managed care operations is preferred.
Prior payer-side experience is strongly preferred.
Strong understanding of hospital reimbursement methodologies, DRGs and payment structures, insurance contracts and contract analysis, revenue cycle operations, and regulatory and compliance requirements related to payer reimbursement is preferred.
Epic experience is preferred; Cerner experience is acceptable.
Ability to translate complex financial and operational data into executive-level presentations and actionable recommendations.
HFMA (Healthcare Financial Management Association) certification is preferred.

Overview

Opportunity based in Fresno, Ca.

Opportunities for you!

Recognized by Newsweek as one of America's Greatest Workplaces for 2026
Eligible for annual incentive program, progressive sign-on incentive and comprehensive relocation package
Community University leadership training courses
Tuition reimbursement, education programs and scholarships
Vacation time accrues from Day 1 at the maximum allowable accrual rate
Free money toward retirement with a 403(b) and matching contributions
Great on-demand dining options, plus free parking and EV charging ordering

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

Responsibilities

As Director, Payer Performance, you’re committed to the positive retention and engagement of your team members. You recognize effective communication as a top priority. You identify as an agent of change, solving organizational challenges through insight and inquiry. Exploring new avenues to help your teams and the organization succeed is central to your work. You’ll stand by decisions in the interest of Community; the popular and the unpopular.

As the Director of Payer Performance, you will lead the strategy, analysis, and optimization of payer reimbursement and contract performance to drive revenue integrity and growth across the health system. You'll serve as a key partner to Finance, Managed Care, Legal, Compliance, and executive leadership, translating complex payer, contractual, financial, and operational data into actionable insights and strategies.

In this role, you'll oversee payer performance analytics, reimbursement variance reviews, denial management, contract modeling, and revenue leakage identification, while leading efforts to resolve underpayments, payment discrepancies, and other payer-related issues. Additionally, you will support contract negotiations and renewal strategies, ensure compliance with regulatory requirements, and develop a high-performing team focused on enhancing payer accountability and improving overall financial performance.

Qualifications

Education

Bachelor’s Degree in healthcare administration, Business Administration, Finance, Accounting, or related field required
Master’s Degree in healthcare administration, Business Administration, Finance, Accounting, or related field preferred

Experience

Five (5) years of healthcare revenue cycle or payer-related experience required
Three (3) or more years of management or leadership experience in a healthcare or payer environment required
Experience developing performance dashboards and executive reporting required
Experience with revenue cycle analytics, business intelligence, or data visualization platforms required

Preferred Experience

Ten (10) or more years of healthcare revenue cycle or payer-related experience preferred
Experience working within an integrated health system or multi-hospital environment preferred
Experience with payer contract management or managed care operations preferred
Prior payer-side experience strongly preferred
Strong understanding of:
- Hospital reimbursement methodologies
- DRGs and payment structures
- Insurance contracts and contract analysis
- Revenue cycle operations
- Regulatory and compliance requirements related to payer reimbursement
Epic experience is preferred, though Cerner experience is acceptable.
Ability to translate complex financial and operational data into executive-level presentations and actionable recommendations.

Licenses and Certifications

HFMA - Healthcare Financial Management Association Certification preferred

Disclaimers

• Pay ranges listed are an estimate and subject to change.
• If any bonuses are noted, they are only applicable to external hires meeting criteria.

About the Company

Community Health System

Regional hospital network delivering medical care

Community Health System operates a regional health network across Central California, running hospitals and care facilities such as Community Regional Medical Center, Clovis Community Medical Center, and Fresno Heart Surgical Hospital. It provides inpatient and outpatient services across specialties including cancer care, neuroscience, orthopedics, obstetrics, pediatrics, cardiology, imaging, and mental health, supported by tools like MyChart for patient access and pre-registration. It differentiates itself by running regional centers of excellence and integrated campuses—such as a cancer center, trauma center, NICU, and specialized heart and brain services—across the San Joaquin Valley. Its goal is to extend advanced medical care, improve patient outcomes, and ensure comprehensive, accessible health services for the Central Valley community.

Company size: 1,001-5,000
Company stage: Grant
Total funding: $10.7M
Headquarters: Clovis, CA
Founded: 1897

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