Director, Payer and Value Based Contracting

Lifepoint Health • Brentwood, TN

2d • Hybrid

About The Position

The Director, Payer Relationships and Value-Based Contracting provides strategic and operational leadership for Advantage Point Health Alliance’s payer relationships and value-based care contract portfolio across Medicare Advantage, Medicaid, Commercial, and ACA lines of business. This role serves as the primary Population Health liaison for payer engagement, contract negotiation support, contract performance oversight, and ongoing relationship management in partnership with Managed Care, network leadership, Finance, Analytics, Quality, Medical Group Services, Legal, and market stakeholders.

Requirements

• Bachelor’s Degree in Business, Finance, Healthcare Administration, or related field.
• Minimum of 5 years of relevant experience in healthcare, managed care, payer relations, value-based care contracting, clinically integrated networks, accountable care organizations, provider network strategy, consulting, or finance.
• Ability to travel up to 10% of the time.

Nice To Haves

• Master’s degree preferred.
• Experience with Medicare Advantage, Medicaid, Commercial, ACA, or other risk-based/value-based reimbursement arrangements preferred.

Responsibilities

• Responsible for the development, management, negotiation support, and performance oversight of Advantage Point Health Alliance’s value-based care payer contracts across Medicare Advantage, Medicaid, Commercial, and ACA lines of business, in accordance with the company’s strategic plan and in compliance with all relevant federal, state, and local regulations.
• Serve as the primary Population Health relationship lead for payer partners, working in close collaboration with Managed Care leaders to source, review, negotiate, implement, renew, and monitor value-based care contracts and associated performance metrics.
• Attend and actively participate in all payer Joint Operating Committee meetings, operational calls, and other payer-facing meetings related to assigned value-based care contracts. Ensure key decisions, action items, performance concerns, contract requirements, and follow-up needs are documented and communicated to appropriate internal stakeholders.
• Maintain a comprehensive master tracker of value-based care contracts, including payer, product line, covered lives, contract term, key quality measures, financial performance indicators, reporting requirements, payment methodology, performance status, risks, opportunities, and assigned action items.
• Monitor contract performance in partnership with Finance, Analytics, Quality, Clinical Operations, Network Directors, and other support teams, with particular focus on quality measure achievement, financial performance, shared savings/shared risk status, care gap performance, utilization trends, and emerging performance risks.
• Prepare concise and actionable summary materials for network board meetings, committee meetings, and internal leadership updates, including payer relationship updates, contract performance summaries, quality measure status, financial performance trends, risks, opportunities, and recommended next steps.
• Assist Network Directors in strategic planning to improve performance under value-based care contracts, including translating payer contract requirements and performance data into actionable market strategies, provider engagement priorities, operational focus areas, and measurable improvement plans.
• Facilitate strategic discussions, build consensus, and support decision-making among payer partners, Net-work Directors, physician leaders, market leadership, Managed Care, Finance, Analytics, Quality, Legal, Clinical Operations, and Health Support Center leadership to advance value-based care contract success.
• Maintain a proactive approach to identifying payer relationship issues, contract performance risks, operational barriers, and emerging value-based care opportunities; develop recommendations and coordinate cross-functional solutions to support long-term success for the Clinically Integrated Networks.
• Provide subject matter expertise on payer contracting, value-based care performance, payer operations, contract metrics, and payer reporting requirements. Stay informed on value-based care program changes, payer market trends, quality measure updates, and reimbursement models impacting Medicare Advantage, Medicaid, Commercial, and ACA contracts.
• Work with Support Teams within the HSC including Managed Care, Legal, Quality, Communications, Finance, Marketing, HITs, Medical Group Services, Hospital Operations Leadership, and local markets to ensure payer contract performance priorities are aligned, tracked, and supported.

Benefits

• Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
• Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Ongoing learning and career advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Director