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Director, Payer Relations

Inovalon, Inc.
life insurance, paid time off, 401(k)
United States, Minnesota, Minneapolis
100 North 6th Street (Show on map)
Jul 07, 2025

Inovalon was founded in 1998 on the belief that technology, and data specifically, would empower the transformation of the entire healthcare ecosystem for the better, improving both outcomes and economics. At Inovalon, we believe that when our customers are successful in their missions, healthcare improves. Therefore, we focus on empowering them with data-driven solutions. And the momentum is building.

Together, as ONE Inovalon, we are a united force delivering solutions that address healthcare's greatest needs. Through our mission-based culture of inclusion and innovation, our organization brings value not just to our customers, but to the millions of patients and members they serve.

Overview: The Director, Payer Relations is responsible for managing and strengthening relationships with payers, clearing houses, and industry partners to support Inovalon's Business Unit. This role focuses on improving transaction performance, leading contract negotiations, and driving initiatives that enhance payer connectivity and reduce claims lifecycle friction. The Director, Payer Relations, will collaborate cross-functionally to analyze metrics, resolve issues, and contribute industry insights to inform strategic planning and ensure regulatory alignment.

Duties and Responsibilities:



  • Strategic Partnership and Network Development:


    • Build and maintain strong relationships with payers, understanding their needs, expectations, and market trends.
    • Establish and maintain strategic relationships with payers, clearing houses, and industry consortiums.
    • Lead negotiations and agreements with new and existing payer partners.


  • Performance & Optimization:


    • Analyze payer connectivity performance metrics and transaction response metrics (e.g., payer not responding, member not found) and lead initiatives to improve outcomes.
    • Ensure high availability and reliability of payer transactions.
    • Gather feedback cross-functionally on connectivity and transaction response metrics to drive enhancement requests and prioritization.


  • Strategic Planning & Execution:


    • Develop and lead the strategy for expanding payer and clearinghouse integrations across all lines of business.
    • Identify opportunities to strengthen payer connectivity, reduce claims lifecycle friction, and improve provider-payer data flow.


  • Contract Negotiation and Management:


    • Negotiate and manage contracts with payers, ensuring favorable terms and compliance with regulatory requirements.


  • Market & Industry Intelligence:


    • Monitor payer requirements, CMS mandates, and interoperability trends to inform roadmap planning.
    • Represent the company in payer and industry working groups, such as WEDI or CAQH.


  • Maintain compliance with Inovalon's policies, procedures and mission statement.
  • Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon's Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position;
  • Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company;
  • Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function; and


  • We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such.


Job Requirements:



  • Minimum of 10+ years of experience in healthcare IT, payer relations, Revenue Cycle Management, or connectivity infrastructure, with 3+ years in a strategic leadership role.
  • Strong understanding of HIPAA EDI transactions (e.g., 837, 835, 270/271), clearinghouse processes, and payer-provider data exchange models
  • Experience with FHIR and CMS interoperability rules.
  • Proven experience of developing and scaling successful partnerships and payer connectivity networks, either at a health tech company, clearinghouse, or payer.
  • Strong experience building payer networks, either at a health tech company, clearinghouse, or payer.
  • Deep understanding of healthcare business models, including providers, payers, digital health, and value-based care.
  • Ability to work with all levels of individuals as a team player or in leadership role.
  • Excellent critical thinking and logical reasoning abilities.
  • Excellent written and verbal communication skills as well as strong presentation skills.
  • Proficient with Microsoft Office, with emphasis on Word, Excel and PowerPoint;
  • Understanding and managing expectations, ability to drive win-win solutions, building and maintaining customer relationships.
  • Self-motivated with strong organizational/prioritization skills and ability to multi-task with close attention to detail.
  • Ability to thrive in fast-paced and changing environments.


Education:



  • Bachelor's degree or equivalent work experience.
  • Master's degree preferred.


Physical Demands and Work Environment:



  • Sedentary work (i.e., sitting for long periods of time);
  • Exerting up to 10 pounds of force occasionally and/or negligible amount of force;
  • Frequently or constantly to lift, carry push, pull or otherwise move objects and repetitive motions;
  • Subject to inside environmental conditions; and
  • Travel for this position is expected to be less than 45%.

Inovalon Offers a Competitive Salary and Benefits Package

In addition to the base compensation, this position may be eligible for performance-based incentives.

The actual base pay offered may vary depending on multiple factors including, but not limited to, job-related knowledge/skills, experience, business needs, geographical location, and internal equity. At Inovalon, it is not typical for an individual to be hired at or near the top end of the range for their role, and compensation decisions are dependent upon the facts and circumstances of each position and candidate.

Inovalon invests in associates to help them stay healthy, save for long-term financial goals, and manage the demands of work and personal commitments. That's why Inovalon offers a valuablebenefits packagewith a wide range of choices to meet associate needs, which may include health insurance, life insurance, company-paid disability, 401k, 18+ days of paid time off, and more.

Base Compensation Range
$126,000 $140,000 USD

If you don't meet every qualification listed but are excited about our mission and the work described, we encourage you to apply. Inovalon is most interested in finding the best candidate for the job, and you may be just the right person for this or other roles.

By embracing inclusion, we enhance our work environment and drive business success. Inovalon strives to provide equal opportunities to the communities where we operate and to our clients and everyone whom we serve. We endeavor to create a culture of inclusion in which our associates feel empowered to bring their full, authentic selves to work and pursue their professional goals in an equitable setting. We understand that by fostering this type of culture, and welcoming different perspectives, we generate innovation and growth.

Inovalon is proud to be an equal opportunity workplace. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirement.

To review the legal requirements, including all labor law posters, please visit this link

To review the California Consumer Privacy Statement: Disclosures for California Residents, please visit thislink

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