Director, Payer Contracting (MA & Medicaid)

Negotiation & Strategy:

Negotiate and renegotiate MA & Medicaid value-based care contracts with prospective payer partners

Proactively engage with payer partners to set and/or improve contract terms

Collaborate with Senior Leadership to qualify and source market growth and expansion for multi-year risk arrangements

Contract Management & Reporting:

Communicate with key, internal stakeholders to ensure a smooth and timely implementation of negotiated terms

Read, draft contract language, and track deliverables to ensure compliance and consistency; Compile data and report updates

Develop and maintain a deep knowledge of existing MA & Medicaid contract terms and act as the internal expert for contract questions

Relationship Management:

Build and manage relationships with payers and other key stakeholders to resolve issues, optimize performance, and identify new opportunities for collaboration.

Minimum Qualifications:

Bachelor’s degree

12+ years in healthcare with health plans or provider groups working on contract negotiations within value-based care

Results-oriented with the ability to exercise influence to achieve goals rather than control

Proven track record of creating, maintaining, and enhancing relationships and communicating effectively with senior management

Exceptional attention to detail in contractual language and processes

Expert sales, business development, growth professional at local and national level

Passionate about driving the shift from fee-for-service to value based care

Preferred Qualifications:

Master’s degree or other advanced degrees in management, health services research, health and/or public policy, or other relevant fields

Physical Requirements:

Prolonged periods of sitting at a desk and working on a computer.