Director, Payer Strategy

Babylist

14h • Remote

About The Position

The Director, Payer Strategy will set the holistic payer strategy for Babylist Health and own the relationships, partnerships, and market intelligence that determine how the company grows its insurance footprint over the next several years. This is not a contracting execution role — it is a senior strategic leadership position responsible for setting the direction, sequencing, and structure of Babylist Health's payer development across both commercial and government (Medicaid) channels.
This person will be the most senior payer leader at Babylist Health, partnering directly with the GM and Finance to model the business case for expansion, represent the company externally at the C-suite level with payer partners, and identify creative growth pathways — including acquisitions, third-party DME partnerships, and trade association strategy — that are beyond the scope of contract execution alone.
The person in this role will manage a team of 3 including the Head of Medicaid Market Development, the commercial payer lead, and a payer operations specialist. They will lead setting the strategy they execute against and serving as the senior escalation point for complex negotiations, regulatory challenges, and payer relationship management.

Requirements

• 12+ years of experience in payer strategy, network development, or government/commercial contracting, with demonstrated success operating at a senior or executive level.
• Deep fluency across both Medicaid and commercial payer landscapes — you understand MCO structures, state-level program administration, reimbursement dynamics, and regulatory environments.
• A relationship network that spans payer C-suites, state Medicaid agencies, and industry trade associations — you know who to call and how to open doors that aren't accessible through standard contracting channels.
• Proven experience setting payer strategy at the organizational level, not just executing it — you've built the roadmap and been accountable for outcomes.
• Comfort with complexity and ambiguity: this is a high-growth environment where strategy and execution are both required, and where the playbook is still being written.
• Experience identifying and evaluating non-standard market entry strategies, including acquisitions, partnerships, or third-party contracting arrangements.
• Strong financial acumen — you can partner with Finance to build the business case, model ROI, and defend trade-offs to senior leadership.
• Health-tech or high-growth company experience is a plus; comfort working in an AI-forward environment where technology accelerates the work is expected.

Nice To Haves

• Background in DME, ancillary healthcare services, or a closely adjacent space is a strong plus.

Responsibilities

• Set the overarching strategy across Medicaid and commercial payers, including covered lives targets, margin objectives, geographic sequencing, and long-term penetration goals.
• Determine how to balance speed of expansion with contract quality — making principled trade-offs between market access, rate, and operational readiness.
• Partner with Finance and the GM to model revenue impact, timing, and ROI of payer initiatives, and ensure payer strategy is tightly integrated with company-level planning.
• Define the strategic framework that guides the Head of Medicaid Market Development and commercial payer lead — including which states to prioritize, which MCOs to target, and how to sequence entry across markets.
• Own operational efficiency- managing the payer operations specialist to ensure signed contracts are billable by the go-live date, existing contracts are maintained in good standing and we are current with all needed licensing and credentialing requirements
• Own payer strategy for new business lines as the Babylist Health business expands beyond DME to other patient services
• Build and cultivate senior-level relationships at MCOs, state Medicaid agencies, commercial payers, and industry trade groups — specifically accessing decision-makers that contract-level outreach cannot reach.
• Represent Babylist Health at industry conferences, trade association events, and payer forums where strategic relationships and market intelligence are developed.
• Serve as the senior external face of the payer function — accountable for relationships that will define the company's payer access for years, not just the current contract cycle.
• Identify and evaluate non-standard pathways to market access, including acquisitions of smaller DME providers, third-party DME partnerships, and white-label or co-contracting arrangements that can accelerate network penetration.
• Develop and drive Babylist Health's strategy for value-added benefit programs, member engagement partnerships, and payer programming beyond core DME contracting.
• Build the case for and lead efforts to influence payer policy and reimbursement trends — including lobbying, trade association engagement, and coalition building where industry headwinds require a proactive response.
• Own Babylist Health's view of the payer landscape — monitoring shifts in reimbursement rates, network policy changes, regulatory developments, and competitive dynamics that affect the business.
• Proactively identify threats (e.g., MCOs reducing reimbursement on product categories) and develop a response strategy before those changes reach the contract level.
• Translate market intelligence into strategic guidance for the GM, Finance, and senior leadership — keeping the company ahead of changes rather than reactive to them.
• Lead and develop the payer team, including the Head of Medicaid Market Development ,commercial payer lead, and payer operations, providing strategic direction and removing barriers to execution.
• Partner closely with Operations, Billing, Legal, Finance, and Product to ensure payer strategy is operationally sound and that expansion doesn't compromise denial rates, AR performance, or patient experience.
• Serve as the internal expert on payer dynamics, educating leadership and cross-functional stakeholders on the complexities of government and commercial contracting.

Benefits

• Competitive salary with equity and bonus opportunities
• Company-paid medical, dental, and vision insurance
• Retirement savings plan with company matching and flexible spending accounts
• Generous paid parental leave and PTO
• Remote work stipend to set up your office
• Perks for physical, mental, and emotional health, parenting, childcare, and financial planning

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed