Director, Payer Operations

Who We Are

Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease deserve the best care. We are committed to improving patient outcomes and improving quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants.

We help nephrologists focus on the right patients at the right time across the full care spectrum. We do this by providing them with the best-in-class interdisciplinary clinical resources, analytical insight and tools, and services to patients. We listen to the needs of our patients, our employees, and our client partners, continually working to push beyond the status quo in which the care system manages patients today.

Who You Are

You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You’re excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change.

Your Role

As a Director, Payer Operations with Evergreen Nephrology, you're responsible for leading and executing key business processes to enhance efficiency and effectiveness in managing a diverse portfolio of health plan contracts. This role involves strategic leadership, operational optimization, and cross-functional collaboration to support value-based care initiatives. 

Role Responsibilities

This role's primary duties include the following:

Leadership & Execution

• Lead complex operational initiatives including practice rostering and policy development.
• Manage a cross-functional team overseeing contract lifecycle management in collaboration with Strategic Payer Partnerships, Legal, Product, and other departments.
• Drive operational excellence, team productivity, and a strong team culture.

Operations Optimization

• Establish and enforce reliable processes across all stages of contract participation (eligibility, roster submission, reconciliation, withdrawal).
• Improve workflows for both existing and new contract flows.
• Implement audit reporting and error-intake processes to proactively detect and resolve discrepancies.
• Lead, organize and implement monthly and quarterly joint payer meetings.

Collaboration with Key Stakeholders

• Partner with internal teams to build systems and tools for accurate roster management.
• Represent business users in product design and development
• Coordinate with teams to ensure data accuracy and alignment with practice rosters.

Other duties consistent with this role, as assigned.

Compensation

The pay range for this role is $140k+ annually. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.  This role is also eligible for an annual bonus.  

Required Qualifications

• Bachelor’s degree in healthcare or related field.
• 10+ years of experience in healthcare operations, including payer contracting or provider credentialing.
• 6–8 years of management experience.
• Strong leadership and stakeholder engagement skills.
• Excellent organizational and analytical abilities.
• Proficiency in contract management systems (CRM)
• Strong verbal, written, and presentation communication skills.
• Intermediate skills with MS Office Suite of products including Outlook and Teams
• Able to work effectively in a primarily remote environment:
  • Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
  • Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
  • Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Preferred Qualifications

• Master’s degree in healthcare or related field