Job Description
- Job Description:
- Establish and lead the enterprise-wide payer contracting vision, strategy, and governance framework across all payer segments.
- Provide executive leadership for high-stakes national and regional payer negotiations, including commercial, Medicare, Medicaid, and specialty agreements.
- Build and sustain executive-level relationships with senior payer, PBM, and network leadership to advance long-term strategic partnerships.
- Oversee advanced financial modeling, scenario analysis, and forecasting to inform executive decision-making and board-level discussions.
- Anticipate and respond to regulatory, legislative, and reimbursement trends that materially impact payer economics and access strategies.
- Partner with executive leaders across legal, finance, clinical, operations, and consulting teams to ensure alignment, risk management, and contract integrity.
- Champion innovative contracting approaches, including value-based, outcomes-based, and alternative reimbursement models.
- Establish performance management, analytics, and reporting standards to ensure payer contract compliance, optimization, and transparency.
- Serve as an executive advisor to clients and internal leaders on payer strategy, market dynamics, and reimbursement optimization.
- Shape, expand, and commercialize payer-focused service offerings that differentiate the organization in the marketplace.
- Requirements:
- Bachelor’s Degree in Business, Healthcare Administration, Finance, Economics, or related field
- Minimum of twelve (12) years of progressive experience in payer contracting, managed care strategy, healthcare finance, or reimbursement leadership
- Advanced payer contracting or managed care certifications a plus
- Deep, enterprise-level expertise in payer reimbursement methodologies across commercial, Medicare, and Medicaid markets
- Proven executive negotiation experience with complex, high-value payer and network agreements
- Advanced financial, actuarial, and economic modeling acumen
- Strong understanding of healthcare policy, regulatory trends, and payer market evolution
- Executive presence with exceptional communication, influence, and relationship-management skills
- Ability to lead senior leaders and drive alignment in a highly matrixed environment
- Strategic, forward-looking mindset with strong ownership and accountability
- Benefits:
- Competitive salary and benefits for this full-time salaried role
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