Director, Payer Contracting
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Director negotiating Medicaid value-based contracts for Equality Health, an integrated healthcare delivery and technology company. Structuring risk arrangements, optimizing payer partnerships, and supporting multi-state market expansion.
Responsibilities:
- Design and support innovative payer contract structures, including shared savings, downside risk, capitation, and bundled payment models
- 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
- Manage executive-level relationships with payer counterparts
- Partner with finance, actuarial, clinical, operations, network development, provider relations, legal, compliance, and analytics teams to operationalize contracts
- Translate contract terms into performance expectations, KPIs, and reporting frameworks
- Monitor medical cost trends, quality metrics, risk adjustment outcomes, and contract performance
- Lead contract renegotiations and optimizations based on performance insights
- Support market entry by establishing payer relationships and securing Medicaid plan contracts
- Identify opportunities to expand existing contracts to new populations, services, or geographies
- Provide stakeholder updates on pipeline, contract status, and financial impact
- Contribute to payer strategy and performance presentation materials
Requirements:
- Associate’s degree or higher and/or equivalent experience in a healthcare or related field of study
- 10+ 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 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 operationalizing contracts cross-functionally in provider or payer organizations
- Excellent negotiation, communication, and relationship management skills
- Preferred: strong relationships with key Medicaid health plans
- Preferred: background in McKinsey & Company, Bain & Company, or Boston Consulting Group with healthcare focus
- Preferred: strong analytical and financial modeling capabilities
- Preferred: MBA, MHA, or related advanced degree
Similar Jobs
Senior Director, Supplemental Providers – Enhanced Benefits
Senior Director overseeing Medicaid supplemental benefits and vendor strategy for CareSource health plans. Leading compliant vendor operations, benefit optimization, governance, and enterprise teams.
Executive Director
Executive Director scaling Munchausen Support Foundation, a nonprofit providing survivor support, research, and education. Leading programs, fundraising, finances, volunteers, and remote operations.
Director, Software Dev Engineer
Engineering Director scaling DeepHealth’s healthcare technology platform and distributed software organization. Driving architecture, delivery, compliance, AI/ML adoption, and executive technology strategy.
Global Commercial Director
Global Commercial Director scaling clearer.io’s AI-powered eCommerce products. Owning direct sales, partnerships and international growth across the UK, EMEA, US and Australia.
Director, Continuous Improvement
Director driving continuous improvement across Alignment Health’s senior-care CX operations. Leading member-centered process optimization, analytics, technology enablement, and cross-functional transformation.
Senior Project Director
Senior Project Director delivering nuclear power EPC projects for GE Vernova. Managing budgets, schedules, suppliers, risks, contracts, and customer satisfaction.
Associate Director, Biostatistics
Associate Director leading statistical strategy and analysis for RayzeBio’s oncology radiopharmaceutical trials. Overseeing clinical trial outputs, vendors, regulatory submissions, and AI-enabled efficiency initiatives.
Enterprise Client Director
Enterprise Client Director shaping strategic accounts for GE HealthCare’s medical technology and care-solutions business. Leading executive relationships, enterprise deals, cross-segment alignment, and account outcomes across Wisconsin or Iowa.
National Director – Facilities
National Facilities Director overseeing ClearSky Health’s hospital infrastructure, Environment of Care, and regulatory compliance. Leading modernization, safety, emergency preparedness, and facilities leadership across multiple healthcare locations.
Senior Director, Embedded Payment Products
Sr. Director leading embedded payment products at WEX, a global commerce platform. Driving payment innovation and solutions that simplify business operations worldwide.
Director, Software Product
Software product marketing leader advancing Varsity Yearbook tools for schools nationwide. Owning roadmaps, launches, customer enablement, and field adoption of digital solutions.
Group Patient Care Director – North Atlantic
Group Patient Care Director leading veterinary technician and assistant teams across VCA Animal Hospitals. Improving patient safety, clinical quality, associate development, and hospital performance across the North Atlantic region.
Director, Payer Contracting
Payer contracting director negotiating Medicaid value-based agreements for Equality Health. Structuring risk arrangements, operationalizing contracts, and expanding payer partnerships across markets.
Director of Strategic Pursuits
RailPros strategic pursuits director growing private railroad and transit clients. Developing Class 1, port, and short-line relationships and expanding engineering services.
Senior Director, Compensation
Senior compensation leader governing global pay, equity, and incentive programs for Calix’s broadband technology platform. Advising executives and the Board while leading compensation strategy worldwide.
Director, Talent – Culture
Director advising Calix Product leaders on AI-enabled talent, culture, and organizational strategy. Driving workforce planning, transformation, and high-performing teams for broadband technology innovation.
Director, Corporate Development
Corporate development director leading healthcare acquisitions, partnerships, joint ventures, and de novo imaging-center expansion. Building valuations, managing diligence, and advising executives on capital allocation.
Executive Director
Executive Director overseeing Texas healthcare markets for HarmonyCares, a national provider of in-home primary care. Managing regional strategy, operations, P&L, teams, and health plan partnerships.
Director, Talent Attraction – Employer Branding
Director shaping national talent attraction and employer branding for Pinnacle Live, an in-house audiovisual and event-production company. Building recruiting strategy, pipelines, systems, and teams across U.S. venues.
Director, Tech Enablement
Papa John's technology operations director managing cloud, infrastructure, support, and production reliability. Driving incident response, compliance, disaster recovery, and operational cost optimization.