Director, Payor Operations

Zocalohealth

Remote, USA
$160,000-$165,000; not specified; not specified py
Remote
Payer requirements operationalization
Health plan performance monitoring
Workflow standardization and evolution
Zócalo Health is seeking a Director of Payor Operations to oversee payer requirements and operational workflows in a remote capacity. The ideal candidate will have extensive experience in healthcare operations, particularly in Medicaid managed care, and will be responsible for ensuring compliance and performance accountability across health plans

Job Summary

  • The Director of Payor Operations will own the payer rulebook, translate requirements into workflows, and drive plan-level performance across the organization.
  • This role involves managing L4 Plan Owners and overseeing the Payor Ops Trainer to ensure clarity and consistent ownership boundaries.
  • Zócalo Health offers an equity compensation package, comprehensive benefits, flexible PTO, and a home office stipend.

Matching Summary

Match Score: 85

Zócalo Health is seeking a Director of Payor Operations to oversee payer requirements and operational workflows in a remote capacity. The ideal candidate will have extensive experience in healthcare operations, particularly in Medicaid managed care, and will be responsible for ensuring compliance and performance accountability across health plans.

Salary

$160,000-$165,000; Not specified; Not specified

Skills & Requirements

Must-have

  • payer requirements operationalization
  • health plan performance monitoring
  • workflow standardization and evolution
  • root cause analysis of issues
  • cross-functional work without authority

Nice-to-have

  • culturally competent primary care
  • value-based care models
  • high-growth scaling organizations

Key Requirements

  • 7-10+ years healthcare operations experience
  • Strong Medicaid managed care knowledge
  • Experience translating requirements into workflows
  • Managing multiple external stakeholders
  • Leading audit, QA, or compliance processes
  • Strong analytical skills
  • Experience with CalAIM programs preferred

Work Rights

Authorized to work in the United States

Tailored Resume

Cover Letter