Opportunity

Reporting directly to the CFO, the Vice President is the primary face of external payer relations who positions the network for financial performance through sophisticated payer strategies which translate the system’s value into reimbursement success.

The VP of Payer Strategy and Relations will be a trusted partner both internally and externally and lead high-impact negotiations, drive strategic alignment across departments and ensure the delivery of fair, mission-aligned agreements with government and commercial payers.

Key priorities include enhancing payer relationships, securing optimal reimbursement terms to align the interests of MLH providers in attractive payer contract negotiations, improving rates and outcomes on fee-for-service contracts in the near-term, as well as building out risk-bearing payment models to create collaborative partnerships with high-value payers and providers in the long-term.

Position Summary

• Lead all aspects of payer engagement including contracting, rates and reimbursement strategy, payer engagement and advocacy, and value-based care innovation to support clinical excellence, financial sustainability, and equitable access to care.
• Requires an experienced and visionary leader with a deep understanding of healthcare quality methodologies, regulatory requirements, and the complexities of a large, integrated health system.

Position Requirements

• Bachelor’s degree in Business, Health Administration, Finance, or a related field required.
• Master’s degree (MBA, MHA, MPH, or related field) strongly preferred.
• At least 10 years of progressive leadership experience in managed care, payer contracting, or healthcare strategy preferably within a health system or integrated delivery network.
• Recent leadership experience with a managed care organization preferred.