Envision Healthcare · 1 day ago
Healthcare- SR DIR OUT OF NETWORK OPS & REIMBURSEMENT SERVICES
United States
Full-time
Remote
Director/Executive
12+ years expEnvision Healthcare is a leading national medical group focused on delivering high-quality care to patients. The Senior Director of Out of Network Operations provides strategic leadership for managing out-of-network claims and arbitration processes, ensuring operational excellence and compliance across service lines.
Health CareHealth DiagnosticsHospitalMedicalMedical Device
Responsibilities
Leads employees by supporting, coaching, training, assisting with time management and performing evaluations; should conduct regular meetings with all direct reports
Defines and executes the strategic roadmap for OON operations, aligning with broader organizational goals and evolving regulatory environments
Oversees the end-to-end arbitration and dispute resolution functions, including strategy, advanced analytics, reporting, and operational execution, ensuring optimal outcomes, compliance with federal/state regulations, and process integrity
Designs and implements scalable workflows, automation, and technology solutions, leveraging tools such as SQL, Tableau, PowerBI, and other advanced analytics platforms to optimize operational efficiency and reimbursement outcomes
Oversees the design and maintenance of executive dashboards and KPIs; provides actionable insights to inform payer strategies and reimbursement optimization
Acts as a strategic liaison across Legal, Revenue Cycle, Compliance, Payer Contracting, and Finance to ensure cohesive execution and enterprise risk mitigation
Drives high-impact initiatives to enhance payer performance, streamline administrative processes, and influence payer behaviors through data and negotiation strategies
Serves as a trusted advisor to the SVP and senior executive team, contributing to enterprise-wide planning, regulatory preparedness, and operational transformation
Accountable for critical operational outcomes that influence enterprise reimbursement performance and regulatory positioning
Applies advanced analytical techniques and data science methods to generate actionable insights, support payer negotiations, and drive enterprise reimbursement strategies
Stays abreast of industry trends, emerging regulations, and competitive practices; proactively adapts strategies to maintain market leadership
Qualification
Required
Strong executive presence and leadership capabilities
Deep understanding of healthcare reimbursement and arbitration processes
Proven ability to lead large teams and complex initiatives
Strategic mindset with strong analytical and communication skills
Comfortable navigating ambiguity and driving change in dynamic environments
Bachelors Degree required
12 years of relevant work experience, including 2 years in healthcare services required
Experience leading cross-functional teams and managing operations at scale
Experience with Excel and tools to manage large datasets (Tableau, SQL, Alteryx, etc) required
Preferred
Consulting or executive-level experience
Benefits
Medical
Dental
Vision
Life
Disability
Healthcare FSA
Dependent Care FSA
Limited Healthcare FSA
FSAs for Transportation and Parking
HSAs
Paid Time Off
9 observed holidays
Paid family leave
Company
Envision Healthcare
Envision Healthcare offers array of healthcare-related services to consumers and hospitals.
10001+ employees
H1B Sponsorship
Envision Healthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2024 (2)
2023 (9)
2022 (2)
2021 (22)
2020 (5)
Funding
Current Stage
Public CompanyTotal Funding
$750M2025-06-25Debt Financing
2018-06-11Acquired
2014-06-18Post Ipo Equity· $750M
Leadership Team
Jason Owen
President & Chief Executive Officer
J. Michael Bruff
Chief Financial Officer
Recent News
Company data provided by crunchbase