Vice President, Payer Contracting & Strategy
About The Position
We are hiring a Vice President, Payer Contracting & Strategy to lead our national payer contracting and managed care strategy, with a focus on strengthening partnerships across commercial, Medicare, and Medicaid health plans. This is a senior executive leadership role for a proven payer expert who understands how payers evaluate risk, structure reimbursement models, and operationalize complex contracts in dynamic healthcare environments. The VP will own the end-to-end payer lifecycle, including payer strategy, contract development and negotiation, reimbursement optimization, and scalable payer operations. This role partners closely with executive leadership and cross-functional teams to support market expansion, value-based care initiatives, and sustainable reimbursement economics across multiple states.
Requirements
- 10+ years of healthcare experience within payer/health plan organizations, risk-bearing providers (IPA/MSO), managed care organizations, institutional providers, home health, hospice, or health technology companies.
- 5+ years of direct payer contracting and/or credentialing leadership experience, with demonstrated success negotiating managed care and primary care contracts.
- Deep relationships and credibility within the payer and managed care ecosystem.
- Strong understanding of reimbursement models, payment methodologies, value-based care, and medical group economics.
- Working knowledge of revenue cycle management (RCM), claims, and payer operations to ensure contracts are operationally executable.
- Experience building or scaling a payer relations or contracting function in a high-growth or tech-enabled healthcare environment.
- Proficiency with MS Office, CRMs, databases, and contract management tools.
- Exceptional written and verbal communication skills, including executive-level presentation abilities.
Nice To Haves
- Experience in a healthcare startup or growth-stage organization.
- Proven ability to define KPIs, establish operational cadence, and drive measurable outcomes.
- Preference for candidates based in Southern California (open to remote candidates).
- Ability to travel periodically to Southern California headquarters and partner sites
Responsibilities
- Own the full payer contracting lifecycle: Lead payer engagement from initial outreach and strategy development through contract submission, negotiation, redlining, execution, renewals, and ongoing relationship management.
- Expand national payer relationships: Leverage an established network and existing relationships to grow partnerships with commercial, Medicare Advantage, and Medicaid payers across multiple markets.
- Lead payer strategy & reimbursement optimization: Define and execute payer partnership strategies that align reimbursement models, operational workflows, and financial performance across service lines.
- Support new market expansion: Drive contracting efforts for new states and markets, working with local, regional, and national health plans.
- Build scalable contracting infrastructure: Develop repeatable systems and processes for payer contracting, credentialing coordination, roster management, compliance, and performance tracking.
- Cross-functional leadership: Collaborate with executive leadership, general managers, credentialing, revenue cycle, and operations teams to translate payer requirements into operational execution.
- Serve as the internal payer expert: Advise leadership on payer policy, regulatory changes, reimbursement trends, and managed care best practices.
- People leadership: Recruit, develop, and lead a high-performing payer contracting and managed care team as the organization scales.
- Perform other related duties as assigned.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Executive
Education Level
No Education Listed
