Director of Payor Strategy and Reimbursement

About the role

The Director of Payor Strategy and Reimbursement leads the Georgia Department of Public Health’s efforts to secure and maximize reimbursement for public health services from Medicaid, PeachCare for Kids, Medicare, commercial insurers and other third‑party payors. This senior position works closely with program offices, the state’s 18 public health districts and external partners to identify reimbursable services, develop payment methodologies and remove barriers to payment.

Key responsibilities

• Serve as the primary liaison with the Georgia Department of Community Health, Medicaid managed‑care organizations, Medicare and commercial insurers.
• Advise DPH leadership and public health districts on payor policies, reimbursement opportunities, coverage requirements and regulatory changes.
• Lead assessments of DPH programs to identify services eligible for third‑party reimbursement and develop standardized billing procedures.
• Develop and implement processes to screen patients for Medicaid, PeachCare for Kids or other coverage and connect them with enrollment resources.
• Monitor policy changes affecting coverage or reimbursement and recommend operational and financial adjustments.

Required profile

• Bachelor’s degree in health‑care services or related field.
• Six years of professional managerial or supervisory experience in health‑care services, or equivalent senior‑level experience.
• Strong understanding of Medicaid and other public and private health‑care reimbursement systems.
• Experience with revenue‑cycle management, medical billing codes, eligibility verification and claims processing.
• Demonstrated project‑management ability; PMP or comparable credential preferred.

What we offer

• Robust benefits package designed for every career stage.
• Workplace flexibility to support work‑life balance.
• Opportunities to collaborate with a dynamic, diverse team dedicated to public health.
• Professional development and long‑term career growth within the State of Georgia.