Senior Director, Payer Programs - Health & Wellness Billing & Reconciliation

Position Summary...

We’re looking for a Senior Director to lead our pharmacy billing and reconciliation work. In this role you’ll lead a team of professionals who support billing, contract planning reconciliation and you’ll also independently own the financial reconciliation process related to our pharmacy. You’ll partner closely with internal stakeholders across Health & Wellness, external payer and vendor partners, and your team to deliver outcomes that improve customer experience, operational performance, and compliance. This position reports to the Group Director of Payer Programs and sits in our Bentonville AR office.

What you'll do...

What you’ll do –

• Lead payer implementations end-to-end for new accounts and major upgrades, including scoping, budgeting, planning, documentation, reporting, and stakeholder communications.
• Oversee implementation support by leading a team that provides customer support during implementation and ensuring defined objectives are achieved.
• Ensure operational setup and accuracy across collections, terminations, pricing, and eligibility configuration.
• Own quality assurance programs by creating and maintaining QA processes/procedures and establishing system checks to ensure eligibility and billing accuracy.
• Manage vendor relationships and contracts by monitoring vendor reporting and reimbursement rates, ensuring claims are processed correctly, identifying system modification needs, and evaluating new vendors.
• Lead risk mitigation and compliance for government and commercial payers by evaluating contracts and guidelines for short- and long-term change requirements and ensuring adherence to federal/state regulations and company standards.
• Set strategic direction by translating business objectives and customer needs into actionable strategies, plans, and practices; forecasting costs; and aligning resources.
• Measure outcomes and improve performance by evaluating operational processes, tracking results, and capitalizing on improvement opportunities.
• Build and develop high-performing teams through talent selection, coaching, mentorship, workforce development, and succession planning.
• Model integrity and ethics by embedding company standards into programs and practices, addressing noncompliance, and supporting the Open Door Policy.
• Strengthen partnerships by collaborating across the Health & Wellness business unit and leveraging internal/external networks to achieve business goals.

What you’ll bring

• Proven leadership experience directing complex, cross-functional implementations (payer, healthcare, benefits, or similarly regulated environments preferred).
• Experience working at a PBM with both reconciliation and billing
• Strong program and project management capability (scope, budget, planning, reporting, stakeholder management).
• Experience with payer operations and post-implementation readiness (eligibility, billing, pricing, collections, terminations).
• Working knowledge of compliance and risk considerations for government and commercial payer programs.
• Track record of developing talent and leading engaged, high-performing teams.

#LI-LB3 At Walmart, we offer competitive pay as well as performance-based bonus awards and other great benefits for a happier mind, body, and wallet. Health benefits include medical, vision and dental coverage. Financial benefits include 401(k), stock purchase and company-paid life insurance. Paid time off benefits include PTO (including sick leave), parental leave, family care leave, bereavement, jury duty, and voting. Other benefits include short-term and long-term disability, company discounts, Military Leave Pay, adoption and surrogacy expense reimbursement, and more. You will also receive PTO and/or PPTO that can be used for vacation, sick leave, holidays, or other purposes. The amount you receive depends on your job classification and length of employment. It will meet or exceed the requirements of paid sick leave laws, where applicable. For information about PTO, see https://one.walmart.com/notices. Live Better U is a Walmart-paid education benefit program for full-time and part-time associates in Walmart and Sam's Club facilities. Programs range from high school completion to bachelor's degrees, including English Language Learning and short-form certificates. Tuition, books, and fees are completely paid for by Walmart.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to a specific plan or program terms.
For information about benefits and eligibility, see One.Walmart.
The annual salary range for this position is $160,000.00 - $320,000.00 Additional compensation includes annual or quarterly performance bonuses. Additional compensation for certain positions may also include :
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Minimum Qualifications...

Outlined below are the required minimum qualifications for this position. If none are listed, there are no minimum qualifications.

Minimum Qualifications: Bachelor’s degree and 6 years’ experience in billing, healthcare, legal, or related area OR 8 years’ experience in billing, healthcare, legal, or related area. 3 years’ supervisory experience.

Preferred Qualifications...

Outlined below are the optional preferred qualifications for this position. If none are listed, there are no preferred qualifications.

Contract Management, Working in or with Pharmacy Benefit Management

Masters: Finance, Masters: Healthcare

Primary Location...

1601 SE 10th St, Bentonville, AR 72716, United States of America

Walmart and its subsidiaries are committed to maintaining a drug-free workplace and has a no tolerance policy regarding the use of illegal drugs and alcohol on the job. This policy applies to all employees and aims to create a safe and productive work environment.