Director Reimbursement Integrity & Payor Analytics

The Director, Reimbursement Integrity & Payor Analytics leads the enterprise strategy for reimbursement variance analytics, payor performance insights, and revenue integrity. This role is responsible for transforming expected vs. actual reimbursement data into actionable intelligence that drives underpayment recovery, reduces overpayment risk, and ensures payor contract compliance. The Director partners closely with the Expected Pay Configuration team to validate model accuracy, support pre-go-live testing, and continuously improve reimbursement modeling outcomes. This position also leads the development of analytics, reporting, and data strategies that enhance transparency and decision-making across revenue cycle and payor relations functions

Company Overview: Envision Healthcare is a leading national medical group focused on delivering high-quality care to patients when and where they need it most. You’ll find clinicians and clinical support professionals across the nation who are proud to call Envision home. We welcome teammates of every background and work in communities that reflect the racial, ethnic, gender, sexual orientation, and economic diversity of our country.

Benefits: At Envision Healthcare, we offer benefits at the speed of your life. Our wide range of health and welfare benefits allow you to choose the right ones for you and your family. Best of all, qualifying employees are eligible to enroll from day one, so you can rest easy knowing you and your loved ones are protected. Envision Healthcare offers a variety of health and welfare benefit options to help protect your health and promote your wellbeing. The benefits offered include but not limited to: Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs.

Paid Time Off: Envision Healthcare offers paid time off, 9 observed holidays and paid family leave. You accrue Paid Time Off (PTO) each pay period and depending on your position and can earn a minimum of 20 days and up to 25 days per calendar year.

• Leads the development and execution of reimbursement integrity and payor analytics strategy across the organization
• Oversees analysis of expected vs. actual reimbursement to identify trends, risks, and opportunities
• Establishes frameworks to categorize reimbursement variances, including underpayments, overpayments, configuration defects, operational exceptions, and contract interpretation issues
• Partners with Expected Pay Configuration leadership to support model QA, validation, and pre-go-live testing
• Identifies systemic payor performance and noncompliance trends and translate findings into actionable insights
• Directs development of dashboards, scorecards, and executive reporting to support financial and operational decisionmaking
• Enables prioritization of variance recovery efforts by providing data-driven insights to Revenue Cycle teams
• Drives reduction of false-positive variance volumes through improved analytics, logic refinement, and data quality
• Collaborates with IT and data teams on data architecture, ETL processes, and reporting optimization
• Leads reimbursement intelligence efforts, including contract interpretation support and insights that inform pricing and negotiation strategies
• Builds and leads a high-performing analytics team, fostering technical excellence and strategic thinking

To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. The requirements listed below are representative of the knowledge, skills and/or abilities required.

• Demonstrated success leading reimbursement analytics, revenue integrity, or healthcare data analytics functions
• Strong expertise in healthcare reimbursement methodologies, payor behavior, and contract structures
• Proven ability to translate complex data into actionable business insights and strategic recommendations
• Experience supporting contract modeling QA, testing, or validation processes
• Strong understanding of data architecture, reporting tools, and analytics methodologies
• Excellent leadership, communication, and cross-functional influence skills
• Ability to identify systemic issues and drive enterprise-level improvements
• Experience collaborating with IT and data engineering teams on analytics and reporting solutions
• High attention to detail and commitment to data accuracy and integrity

Education/Experience

• Bachelor’s degree required; advanced degree preferred
• 8–12 years of experience in healthcare analytics, reimbursement, or revenue cycle functions ▪ 4+ years of leadership experience
• Demonstrated success leading analytics, reporting, or reimbursement integrity initiatives
• Progressive experience in data-driven healthcare financial operations

If you are ready to join an exciting, progressive company and have a strong work ethic, join our team of experts! We offer a highly competitive salary and a comprehensive benefits package.

Envision Healthcare uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify .

Envision Healthcare is an Equal Opportunity Employer.