Vice President, Payer Contracting

Q Point Health LLC• US,

About The Position

Equality Health is seeking a dynamic, results-oriented Vice President of Payer Contracting to lead the strategy, negotiation, and execution of value-based agreements with Medicaid managed care organizations (MCOs). The role is central to expanding and optimizing payer partnerships that support high-quality, cost-effective care for underserved populations. The VP works at strategic and tactical levels, structuring complex risk arrangements and ensuring contracts are operationalized effectively across markets. The role calls for deep expertise in Medicaid reimbursement, value-based care models, and payer-provider dynamics. Equality Health is an integrated, holistic, tech-enabled healthcare delivery system focused on improving the health and wellness of diverse populations. Founded in 2015, the company supports more than 800,000 members and over 4,000 practice sites. Its value-based care platform combines practice transformation and performance support, proprietary technology, value-based provider incentives, and multidisciplinary care teams. Equality Health partners with managed care organizations and operates in Arizona, Texas, Louisiana, Virginia, and Tennessee.

Requirements

10–15+ years of experience in payer contracting, network management, or healthcare business development.
Deep expertise in Medicaid managed care and value-based payment models.
Proven track record of negotiating and managing complex, risk-based contracts.
Strong understanding of healthcare economics, including medical cost drivers, risk adjustment, and quality incentives.
Experience working with or contracting on behalf of Medicaid managed care organizations, MSOs, ACOs, or risk-bearing provider groups.
Experience in multi-state Medicaid environments and familiarity with state-specific regulations.
Experience working cross-functionally to operationalize contracts in provider or payer organizations.
Excellent negotiation, communication, and relationship management skills.

Nice To Haves

Strong, trusted relationships with key Medicaid health plans.
Background in a top-tier consulting firm such as McKinsey & Company, Bain & Company, or Boston Consulting Group, with a healthcare focus.
Strong analytical and financial modeling capabilities.
MBA, MHA, or related advanced degree.

Responsibilities

Develop and mature the organization’s payer contracting strategy, focusing on Medicaid value-based arrangements.
Design contract structures such as shared savings, downside risk, capitation, and bundled payments.
Align contracting strategy with enterprise growth goals, clinical models, and financial targets.
Lead end-to-end negotiations with Medicaid managed care organizations and other payer partners.
Own and manage executive-level relationships with payer counterparts, positioning Equality Health as a preferred partner for value-based care delivery and population health management.
Partner with finance, actuarial, clinical, and operations teams to ensure contracts are financially sound and operationally executable.
Translate contract terms into performance expectations, KPIs, and reporting frameworks.
Monitor contract performance, including medical cost trends, quality metrics, and risk adjustment outcomes.
Lead renegotiations and contract optimizations based on performance insights.
Collaborate with network development, provider relations, and clinical teams to align incentives and support provider readiness for risk-based models.
Work with legal and compliance teams to structure contracts that meet regulatory requirements.
Partner with finance and analytics teams on pricing, forecasting, and performance measurement.
Support entry into new markets by establishing payer relationships and securing contracts with Medicaid plans.
Evaluate RFP opportunities and lead payer-related components of proposal development.
Identify opportunities to expand existing contracts to new populations, services, or geographies.
Participate in the Contract Review Committee and lead where necessary, applying contracting governance processes such as approval frameworks and performance reviews.
Provide executive leadership with regular updates on pipeline, contract status, and financial impact.
Contribute to board-level materials related to payer strategy and performance.