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