Director of Revenue and Payer Operations

Reposted 5 Days Ago
Hiring Remotely in United States
Remote
145K-160K Annually
Senior level
Healthtech
The Role
The Director of Revenue and Payer Operations will manage payer contracting, optimize contract performance, and provide strategic frameworks for growth in a digital addiction medicine clinic.
Summary Generated by Built In

About this role

We’re looking for a strategic, detail-oriented, and highly analytical Director of Revenue and Payer Operations to serve as a key internal leader in our growth efforts. You’ll play a critical role in structuring frameworks for new market entry, scaling go-to-market processes, optimizing contract performance, and driving revenue growth. You’ll report directly to the Head of Growth Partnerships and work closely with the Associate Director of Value-Based Contracting, Partnerships Manager, and Directors of RCM, Product, and Data.

This is a hands-on role that blends financial analysis, operational oversight, and strategic guidance. You'll be a great fit for this role If you have deep healthcare finance and contracting expertise, thrive in a data-driven environment, and can move seamlessly between strategy and execution.  

Success in this role

Contracting & Operations

  • Manage operational tracking for the payer contracting function, including reimbursement terms, pipeline reporting, and forecasting
  • Conduct fee schedule analyses, assess financial impact, and advise on coding/reimbursement alignment to support performance under value-based contracts
  • Build and maintain financial models to inform rate negotiations and track contract performance
  • Partner with Finance and Operations to ensure smooth contract implementation
  • Support large or complex contract opportunities, ensuring cross-functional alignment

Strategy & Market Development

  • Research and analyze Medicaid policy, market dynamics, and competitor positioning to inform market entry strategy
  • Develop strategic frameworks for growth, including FFS optimization and value-based contracting readiness
  • Advise leadership on opportunities and risks tied to payer strategy
  • Provide modeling, research, and contracting insights to support business development initiatives

Performance Tracking

  • Monitor contract performance against metrics and targets
  • Track payments, quality measures, and incentive programs, identifying gaps and opportunities
  • Partner with Finance and Ops to ensure reporting accuracy and compliance
  • Develop dashboards and reporting to guide business decisions and optimize payer strategy
  • Deliver regular KPI reporting to leadership, highlighting risks and opportunities

Internal Partnership & Stakeholder Management

  • Act as the central business partner for internal teams (Data, Product, Finance, Clinical) on payer strategy and operations
  • Create and maintain source-of-truth documents and dashboards
  • Take on high-priority special projects to advance payer-facing growth

Requirements

  • Minimum 5 years in healthcare contracting, strategy, consulting, or payer/provider partnerships
  • Expertise in fee schedules, coding, and reimbursement analysis
  • Strong understanding of Medicaid programs and value-based care models
  • Proven track record managing complex projects and delivering insights to senior leadership
  • Analytical, detail-oriented, and an excellent communicator, with the ability to move between high-level strategy and hands-on execution

Work environment

  • This is a fully remote role but we are currently only hiring candidates located in the following states: AZ, CA, CO, FL, GA, ID, IL, KY, MA, NC, NJ, NY, OH, OR, PA, SC, TN, TX, UT, WA, and WV. Applicants must reside and work in one of those states to be considered.
  • Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.
  • Office Requirements: Boulder teammates working with sensitive information must have a dedicated, private workspace with a lockable door and high-speed internet to maintain a secure, distraction-free environment, ensuring compliance with HIPAA and confidentiality standards
  • Boulder Care employees are free to use our river-front HQ located in Portland, OR whenever they would like

Expected hours of work

This is a full-time remote position expected to work 40 hours between Monday-Friday.

Compensation

The starting pay range for this position is $145,000 - $160,000; base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience. The total compensation package for this position may also include other elements, including equity grants in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave).

Some of Boulder’s amazing benefits for regular, full-time employees

  • Contribution to meaningful, life-saving work!
  • Comprehensive medical, dental, vision, and short-term disability benefits designed to take care of our employees and their families 
  • Mental Health Services via Regence, Doctors on Demand, and EAP for continuous care
  • 4 weeks of vacation accrued per calendar year with a tenured increase to 5 weeks at 2 years of employment
  • Sick leave accrued at 1 hr for every 30 hrs paid
  • 9 Paid Holidays per year
  • 12 weeks of 100% paid parental leave for the birth or adoption of a child (after 6 months of employment)
  • 401(k) retirement savings
  • Remote friendly with hardware provided to complete your work duties

Our values

  • The people we care for always come first
  • Our opportunity is also our duty, in service to others
  • Share facts to change minds, instill empathy to change hearts
  • Move the industry forward: follow the data
  • Strong individuals, stronger together

Boulder Care believes the people who manage our product and team should be representative of those who use the platform. This includes people from backgrounds that are historically underrepresented in the industry. We celebrate differences and are committed to equal employment opportunities regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, citizenship, marital status, disability, gender identity or veteran status. If you are a qualified person with a passion for what we do, please apply!

Top Skills

Financial Modeling
Medicaid Programs
Value-Based Care Models
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The Company
HQ: Portland, OR
93 Employees
Year Founded: 2017

What We Do

Telehealth addiction treatment on your terms and timeline - grounded in kindness, respect, and unconditional support.

At Boulder Care, we help people with substance use disorders reach their goals through judgement-free recovery support and evidence-based addiction treatment, rooted in the principles of harm reduction. Patients can access their Care Team — a Clinician, a Care Advocate, and a Peer Recovery Specialist — through secure messaging, video visits, and phone support from an app on their phone.

By championing low-threshold access to medications for addiction treatment, Boulder improves clinical and functional outcomes — sharing in the cost savings with health plan and employer partners under a value-based model.

We are proud to offer millions of Americans access to Boulder as an affordable in-network provider and affordable self-pay options to those who need it.

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