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Provider Payment Director, Scotts Valley, CA

Organization: Central California Alliance for Health
Category: Director
Location: Scotts Valley, CA
Date Job Posted: March 25, 2020
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Provider Payment Director
Scotts Valley, CA

We have an opportunity to join the Alliance as the Provider Payment Director leading the Cost Efficiency Department.


Reporting to the Chief Financial Officer, you will provide strategic management oversight in implementing, directing and monitoring the Alliance’s Provider Payment Department functions. You will direct the Provider Payment Department, act as a subject matter expert, and provide executive level advice and guidance on provider payment functions and overall business operations.You will also direct, manage, and supervise Provider Payment Department staff.


  • Expertise in developing, implementing and monitoring provider payment strategies, including rate analysis
  • Experience in overseeing and preparation of Rate Development Templates
  • Strong experience in financial data and healthcare cost analytics
  • Excellent communication skills and the ability to partner with cross-functional teams
  • Ability to lead and inspire others, while promoting an environment that supports professional growth, embraces complex challenges and celebrates accomplishments


Knowledge of:

  • The managed care industry
  • Medicaid, entitlement programs and related regulations
  • Research, analysis and reporting methods
  • The application and utilization of data and analytics to drive critical financial decisions
  • Standard negotiating and marketing techniques
  • Principles and practices of supervision and training

Ability to:

  • Demonstrate strong analytical skills, accurately collect, manage and analyze data, identify issues, offer recommendations and potential consequences, and mitigate risk
  • Perform complex analysis related to rate negotiations, health care cost reports, and determination of rates for hospitals, clinics, long term care facilities, allied health services, professional services and specialist services
  • Exercise sound financial management in making decisions
  • Direct, manage, supervise, mentor, train, and evaluate the work of staff
  • Develop, plan, organize, and direct finance programs and activities that are complex in nature and regional in scope

Education and Experience:

  • Bachelor’s degree in Finance, Business, Accounting or a closely related field
  • A minimum of ten years of experience in finance, analytics, or contracting, which included a minimum of two years of experience related to Medicaid and Medicare Managed Care Programs and a minimum of three years of supervisory experience (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying


  • Medical, Dental and Vision Plans
  • Ample Paid Time Off
  • 11 Paid Holidays per year
  • 401(a) Retirement Plan
  • 457 Deferred Compensation Plan
  • Robust Health and Wellness Program
  • EV Charging Stations
  • And many more

For a complete position description and to apply online, please visit our careers website at


We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve approximately 340,000 members in Santa Cruz, Monterey and Merced counties. To learn more about us, click here or check out this video.

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for sponsorship.

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