Director Payer Contracting & Strategy

Position Summary

We are hiring a Director of Payer Contracting & Strategy to own and lead our national payer contracting and managed care strategy across commercial, Medicare Advantage, and Medicaid health plans.

This is a leadership role for a proven payer expert who understands how payers assess risk, structure reimbursement models, and operationalize complex managed care contracts in dynamic, multi-state healthcare environments.

The Director 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.

Key Responsibilities

• Own the full payer contracting lifecycle: Lead payer engagement from strategy and outreach through contract submission, negotiation, redlining, execution, renewals, and ongoing relationship management.

• Expand national payer relationships: Leverage deep existing relationships to grow partnerships with commercial, Medicare Advantage, and Medicaid payers across multiple markets.

• Lead payer strategy and reimbursement optimization: Design and execute payer strategies that align reimbursement models, operational workflows, and financial performance.

• Support new market expansion: Drive payer contracting for new states and markets, working with local, regional, and national health plans.

• Build scalable contracting infrastructure: Develop repeatable systems and processes across payer contracting, credentialing coordination, roster management, compliance, and performance tracking.

• Cross-functional leadership: Partner with executive leadership, general managers, credentialing, revenue cycle, and operations teams to translate payer requirements into operational execution.

• Serve as the internal payer authority: Advise leadership on payer policy, regulatory changes, reimbursement trends, and managed care best practices.

• People leadership: Build, develop, and lead a high-performing payer contracting and managed care team as the organization scales.

Minimum Qualifications

• 7+ years of healthcare experience within payer 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 a strong track record negotiating managed care and primary care contracts.

• Established payer relationships and credibility across the managed care ecosystem.

• Deep 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.

• Strong executive communication skills; comfortable presenting to senior leadership.

• Proficiency with MS Office, CRMs, databases, and contract management tools.

Preferred Qualifications

• Experience in a healthcare startup or growth-stage organization.

• Proven ability to define KPIs, establish operating cadence, and drive measurable outcomes.

• Preference for candidates based in Southern California (open to remote).

• Ability to travel periodically to Southern California headquarters and partner sites.