Payment Reimbursement Manager

Job title: Payment Reimbursement Manager

About the Role Advise clients on reimbursement strategy, payment reform, and provider financial sustainability across Medicaid, rural health, and broader healthcare markets. The successful candidate will combine deep domain expertise with strong consulting judgment and will be expected to manage teams, advise senior clients, and deliver complex engagements in reimbursement and payment strategy. This individual will build trusted client relationships and help clients design sustainable reimbursement approaches aligned to their strategic goals.

As a Payment Reimbursement Manager, your primary responsibilities may include:

What You'll Do

• Advise clients on reimbursement strategy, payment model options, and provider finance issues across Medicaid, rural, and safety-net settings.
• Advise clients on assessing current reimbursement approaches and identifying opportunities to improve reimbursement adequacy, strengthen incentives, and support provider sustainability.
• Develop recommendations on payment model design, reimbursement redesign, provider stabilization, and implementation approaches.
• Translate complex reimbursement issues into clear decision materials, executive presentations, and practical roadmaps.
• Manage day-to-day engagement delivery, including work planning, team coordination, quality review, and client communications.
• Work across finance, policy, analytics, and operations teams to develop integrated recommendations.
• Build relationships with senior client stakeholders, facilitate working sessions, and help identify follow-on opportunities in reimbursement and payment transformation.
• Travel: As required, up to 80%.

What We're Looking For

• Minimum of 5 years of experience with Medicaid payment strategy, provider reimbursement, payment reform, or provider finance.
• Minimum of 2 years of experience assessing reimbursement adequacy, provider incentives, and financial sustainability across hospitals, rural providers, FQHCs, behavioral health providers, or other safety-net settings.
• Minimum of 2 years of experience translating state or federal priorities into viable reimbursement structures or implementation approaches.
• Bachelor's Degree.

Nice to Have

• Medicaid managed care & contracting experience: Exposure to MCO/PIHP/PAHP structures; familiarity with rate setting concepts, actuarial soundness, value‑based purchasing, and network/provider contracting approaches.
• Payment reform implementation leadership: Experience designing and implementing value‑based purchasing, quality incentives, withholds, episode/bundle models, and performance measurement that align incentives without destabilizing providers.
• Regulatory and waiver familiarity: Working knowledge of Medicaid policy mechanisms.

Compensation & Benefits

• Salary and benefits not disclosed in the posting.