Director, Payer Contracting (MA & Medicaid)

Primary Duties

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.