Director Government Payment Programs-SWHR

Director Government Payment Programs-Southwestern Health Resources-Clinically Integrated Network (SWHR-CIN)

At Southwestern Health Resources (SWHR), we believe healthcare can be more integrated, accessible, and affordable for all. Our purpose is simple yet powerful: to build a better way to care, together. SWHR is a patient-centered, clinically integrated network that brings together academic and community clinicians, researchers, hospitals, and ambulatory facilities. We partner with physicians to drive a new model of value-based, high-quality, data-driven healthcare—serving everyone in the communities we touch.

By combining the strengths of UT Southwestern Medical Center and Texas Health Resources, we’ve built the largest provider network in North Texas, giving our team members the opportunity to make a meaningful impact at scale. Healthcare in the U.S. is evolving rapidly, and SWHR is committed to leading that change—moving healthcare forward, together.  

Position Summary

The Director of Government Payment Programs provides strategic, operational, and analytic leadership for Southwestern Health Resources (SWHR) Clinically Integrated Network's (CIN) participation in government-sponsored healthcare programs. This includes oversight of all voluntary and mandatory programs, and government sponsored managed care. This position serves as a bridge between regulatory agencies, payer partners, and network providers, implementing complex government program requirements and actionable strategies that drive value, efficiency, and clinical integration.

·  Work location: Hybrid-remote and in the home office: Southwestern Health Resources Headquarters, Farmers Branch, TX.

Position Duties

Lead the execution of SWHR CIN’s multi-years strategies for successful government program participation and performance, driving over $4 billion in annual claims expenditures and nation-leading program outcomes.

Lead the comprehensive evaluation of emerging federal and state payment models. Make participation recommendations to executive leadership. Anticipates implications of decisions and navigates politics diplomatically.

Lead senior leaders through complex decisions, accounting for multiple stakeholder perspectives and ensuring alignment with broader strategies for the Clinically Integrated Network. Reviews outcomes and adjusts decision frameworks to improve future choices.

Lead the planning and execution of new programs and major program changes to meet stringent regulatory timelines and requirements. Balances interests and negotiates agreements that enable join execution. Drives others to take timely action.

Lead corrective actions to correct performance or compliance deficiencies, and to maximize program performance. Holds others accountable for making sound decisions that comply with policies and standards.

Lead the integration of government program objectives into network development strategy, care model design and delivery, and value-based care contracting approaches.

Oversee government payment programs administration and operations to tightly manage organizational risk, ensuring compliance with all program and regulatory requirements.

Monitor government program activities, program data and outcomes to identify trends, pinpoint areas for improvement, and proactively inform data-driven decision-making.

Prepare and deliver comprehensive performance reports, summaries, and presentations for CIN executives, SWHR senior leaders, and physician network partners to communicate government programs status, milestones, changes, and challenges.

Supply relevant and timely policy intelligence to leadership to inform SWHR CIN governance and contracting decisions. Synthesizes information, experience, and various inputs to determine the best course of action.

Develop incentive models that align employee and provider behavior with SWHR CIN goals and program sustainability.

Be the trusted advisor and subject matter expert to physician leaders and participating practices throughout the clinically integrated network on government program requirements and performance opportunities.

Represent SWHR CIN in meetings with industry organizations, professional associations, and government agencies to advocate for CIN priorities and ensure compliance.

Sets department KPIs and operating cadences that reinforce ownership. Holds managers accountable for commitments and ethical standards. Monitors metrics and milestones to push progress against expectations and accountabilities. Track progress on key departmental initiatives.

Staffs and structures teams with clear roles, interfaces and decision rights. Develops managers and creates norms for accountability, inclusion and continuous improvement. Aligns goals across teams and coordinates dependencies to deliver integrated outcomes.

Perform all other duties, as assigned.