Director, Payer Account Management

Type of Employment: Full Time
Department: CPO
Location: Nashville, TN
Travel: 15%-25% (based on client requirements)


The Director of Payer Account Management is responsible for developing extraordinary rapport with Shearwater Health clients, understanding client needs, guiding go-live processes in concert with Clinical Process Outsourcing (CPO®) leadership in the Philippines with training support when within the area of expertise, mapping of agreed client functions appropriate for Shearwater Health CPO®, account revenue growth, and customer satisfaction and retention of assigned Shearwater Health client base.

Required Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill, and/or ability required.

  1. Ability to anticipate, identify, and resolve problems in a timely manner; gather and analyze information skillfully; and generate reports as needed
  2. Ability to demonstrate accuracy and thoroughness, monitor own work to ensure quality and apply feedback to improve performance.
  3. Ability to adapt to changes in the work environment, manage competing demands, and manage frequent changes, delays and/or unexpected events.
  4. Possess the ability to understand financial budgeting and performance indicators
  5. Ability to work independently and in team collaboration, including being adaptable to occasional need outside traditional work hours.
  6. Detail oriented to process mapping and workflow planning.
  7. Computer skills (Microsoft applications) with strength in Excel, PPT, and Word as well as planning programs.
  8. Excellent written and verbal communication skills with required client presentations in person and remotely.

Preferred Qualifications:

  1. Bachelor’s Degree or higher with previous client facing work experience
  2. Experience working within a Health Plan strongly preferred
  3. Knowledge and experience in Quality (HEDIS, Supplemental, and Risk Adjustment Coding) and/or Utilization Management within a Health Plan a plus


  1. Performs regular customer contact, including, weekly, bi-weekly, and/or monthly calls and routine business reviews with all clients to anticipate client needs, ensure satisfaction, identify potential or present performance issues, etc.
  2. Learns and manages each client contract to ensure Shearwater Health is managing to the agreed upon terms and that client billing is on time and accurate.
  3. Learns and documents work within the Salesforce application following the Shearwater Health procedures.
  4. Be active owner with Finance and Operations in client budget forecasting process
  5. Navigates client environment with discretion, grace, and political and interpersonal sensitivity to ensure Shearwater Health and client goals are defined, documented and achieved in an environment where some client employees may resist change presented by Shearwater Health.
  6. Maintains a balanced position when confronted with client concerns; demonstrates sensitivity towards customer issues, while ensuring that Shearwater Health’s policies, profitability and marketplace reputation are protected.
  7. Serves as an expert listener and communicator with the designated client leadership and with Shearwater Health leadership about potential and developing client – Shearwater Health opportunities.
  8. Ensures the delivery of excellent service by assisting with new client implementation, researching to resolve issues and problems; creating and delivering reports as needed for the client.
  9. Collaborate with Operations and Clinical Leadership in the United States and in the Philippines to ensure client directives are clearly defined.

Why Shearwater?

Shearwater Health (formerly HCCA International) pursues a mission of improving healthcare outcomes globally. Founded in 1973, we have continually developed our clinical staff to meet the needs of healthcare providers, payers, and any company with needs that require skilled clinical experience.

Headquartered in Nashville, TN, we provide outsourced clinical services for Providers, Payers, Workers’ Comp & Disability insurers, and Pharma & Life Sciences companies. We have over 2,000 clinicians in our URAC-accredited and HITRUST-certified facilities in the Philippines that operate in remote teams for our clients. We couple our clinical expertise with Six Sigma business experts and Robotic Process Automation to improve outcomes and lower costs. We also credential, provide visa authorization for, and employ international nurses at U.S. hospitals and partner with international hospitals and organizations to cultivate a supply of skilled nurses around the world.

Employee Benefits:

• A competitive salary
• Comprehensive health insurance
• 401(k)
• Paid holidays
• Paid vacation and sick time
• The opportunity to build your career in a rewarding and unforgettable way