Director, Payer Strategy – Contracting

Job Description: • Plan, develop, direct, coordinate and monitor all activities to successfully bring our product and services to new payers • Navigate contract strategy, negotiations, and renegotiations to optimize partnership structure and success • Manage contract negotiations with current and future Medicaid and commercial payers • Own pricing model and reviewing of unit economics for each contract • Leverage data to generate insights and identify new opportunities for payer partnership growth • Collaborate with cross functional, internal stakeholders to deliver insights to inform product operations and strategy • Evaluate current and potential new geographic areas for new business opportunities • Oversee policy and regulatory environment and serve as an expert level resource related to business review of all contracts, amendments, and correspondence • Collaborate with the Finance and Product teams to develop alternative payment models and ensure delivery of engagement and outcome based performance • Identify opportunities for enhanced relationships, reimbursement, referrals, and a growing market presence • Prepare forecasts and advise the Executive Leadership Team (ELT) on all matters concerning net revenues in the areas of Medicaid and commercial partnerships • Drive sales to increase revenue growth with new (and renewed contracts) to expand Cayaba Care’s value-add to healthcare payer clients, and increase overall domain footprint • Identify and capture add-on, new capability, and cross-sell opportunities to drive sales and revenue growth within the healthcare payer industry • Work closely with the CEO to explore new sales opportunities and ensure a unified approach to payer partnership and contract management • Develop and recommend payer pricing, contracting and operational strategies to optimize the long-term financial profitability of the company • Work closely with the Finance team to evaluate, source, design, recommend, and monitor the execution and effectiveness of processes designed to ensure timely and accurate reimbursement from payers Requirements: • Bachelor’s Degree in business, communications, health administration or a related field required • MBA or equivalent • 7+ years experience in healthcare payer strategy or consulting in payer contracting space • Deep understanding and experience with developing and negotiating payer contracts, particularly for Medicaid MCOs; commercial payer experience is a plus • Deep network and previously established relationships with Medicaid payers • Experience with successful value-based contracting options for specialty services with Medicaid or commercial payers • Excellent written and interpersonal communication skills including active listening, self-management and awareness, emotional intelligence, and a high degree of integrity and professionalism • Proven financial acumen and ability to identify the impact of changes on budget goals and financial targets • Experience facilitating buy-in and engagement across diverse stakeholder groups • Ability to anticipate risks and mitigate effectively • Proven experience selling to C-level executives nationally • Proven record of exceeding sales quota • Experience with Hubspot, Google Suite required • Experience with Series A - Series C start-ups • Ability to travel as needed (up to 30%) for meetings and conferences • Experience in women’s health, pediatrics and specialty populations a plus. Benefits: • Recharge with annual paid holidays off. • Salaried (Exempt) Employees: Enjoy unlimited time off after the 90-day probation period. • Full-Time (Non-exempt) Employees: Receive three weeks of paid time off after the 90-day probation period. • Medical Insurance: Access top-tier healthcare, covering hospital, surgical, and prescription drug benefits. Coverage begins the first of the following month. • Dental Insurance: Coverage for preventive care, as well as basic and major procedures. • Vision Insurance: Coverage for routine eye exams and eyeglasses. • Life Insurance: Financial protection for your beneficiaries. • Disability Insurance: Short-term and long-term coverage in case of illness or injury. • 401(k) Retirement Plan: Opportunity to save for the future. Apply tot his job Apply To this Job