Director, Revenue Cycle Payer

Director, Revenue Cycle Payer Performance

Join to apply for the Director, Revenue Cycle Payer Performance role at Baylor Scott & White Health
. The role is under the direction of the Vice President, Revenue Cycle Support Services, and focuses on strategic efforts to identify and correct issues related to commercial underpayments and denials. The director serves as a critical liaison between Revenue Cycle leadership and Managed Care leadership to support and streamline payer communications, develop tools to monitor reimbursement, track revenue opportunities, and ensure ongoing adherence to implemented solutions.

This position does not have direct reports but functions within a matrixed organizational structure, collaborating closely with teams across Revenue Cycle, Managed Care, Finance, and Operations.

Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott & White is the largest not‑for‑profit healthcare system in Texas that empowers you to live well.

• We serve faithfully by doing what's right with a joyful heart.
• We never settle by constantly striving for better.
• We are in it together by supporting one another and those we serve.
• We make an impact by taking initiative and delivering exceptional experience.

Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include:

• Immediate eligibility for health and welfare benefits
• 401(k) savings plan with dollar‑for‑dollar match up to 5%
• Tuition Reimbursement
• PTO accrual beginning Day 1

Note:

Benefits may vary based on position type and/or level.

Under the direction of the Vice President, Revenue Cycle Support Services, the Director, Payer Performance leads Revenue Cycle’s strategic efforts to identify and correct issues related to commercial underpayments and denials. This role serves as a critical liaison between Revenue Cycle leadership and Managed Care leadership to support and streamline payer communications. The Director will also develop tools to monitor reimbursement, track revenue opportunities, and ensure ongoing adherence—by both BSWH and commercial payers—to implemented solutions.

• Develop effective communication channels across the Revenue Cycle to identify commercial payer trends, underpayments, and opportunities for BSWH revenue improvement.
• Track denials and avoidable write‑offs (AWOs) across all regions; improve efficiency of regional work groups by coordinating scalable, system‑wide solutions.
• Drive resolution of all payer‑related revenue opportunities by coordinating across internal stakeholders and third‑party vendors.
• Serve as the central point of contact for Revenue Cycle, Finance, and Operations regarding commercial payer issues and outstanding concerns.
• Manage projects related to revenue optimization and denial mitigation, ensuring timely delivery and adherence to budget constraints.
• Support Revenue Cycle leadership with strategic planning and prioritization of key commercial reimbursement projects based on financial impact.
• Represent Revenue Cycle’s interests in contract negotiations; maintain a strong working knowledge of managed care contract language and operational implications.
• Provide actionable feedback to inform BSWH payer scorecards and performance evaluations.
• Assist the Managed Care department in preparing for regular payer meetings, including surfacing operational issues and identifying opportunities for improved performance.
• Develop and maintain process workflows for communicating and implementing contract updates that affect Revenue Cycle functions.
• Partner with the Revenue Analytics team and Managed Care to assess financial impacts of commercial contract changes and ensure alignment with reimbursement expectations.
• Co‑de‑velop reporting and analytics tools to proactively monitor reimbursement trends, identify underpayments, and uncover additional revenue opportunities—including denial patterns.
• Leverage automation opportunities and system…