Director, Payor Operations

7–10+ years of experience in healthcare operations, payer operations, compliance, or related functions

Strong working knowledge of Medicaid managed care and payer-driven program requirements

Demonstrated experience interpreting payer or regulatory requirements and translating them into operational workflows

Experience managing multiple external stakeholders (health plans, partners) with differing requirements

Experience leading or supporting audit, QA, or compliance processes

Experience working with CalAIM programs (ECM, Community Supports)

The Director of Payor Operations will join Zócalo Health during a period of increasing payer complexity and operational scale.

This role exists to ensure payer requirements are clearly defined, consistently operationalized, and executed accurately across the organization. You will own the payer rulebook, translate requirements into workflows, and drive plan-level performance.

The Director, Payor Operations

Payer Rulebook & Workflow Definition

Own and maintain a centralized payer rulebook across all health plans

Interpret payer requirements and translate them into clear operational workflows

Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the one-size-fits-all  healthcare system. We partner with health plans, providers, and community organizations to deliver culturally competent primary care, behavioral health, and social care.

Our model is built for populations with high medical and social complexity, where fragmented care drives poor outcomes and unnecessary cost. We combine local, community-based teams with virtual care and modern technology to deliver coordinated, whole-person care where members live and receive support.

Founded in 2021, Zócalo Health is backed by leading healthcare and mission-aligned investors and is scaling rapidly across states and populations. We are building a durable care platform designed to perform in constrained healthcare environments and to lead the shift toward accountable, value-based care.