Director, Health Plan Contracting

Groups Recover Together; United States; Remote; USD 80,000 - 120,000; Full time

Job summary

An established industry player is seeking a Director of Health Plan Contracting to drive their expansion into new markets. This role involves developing partnerships with health plans, articulating the unique value proposition of their care model, and navigating complex negotiations to secure beneficial contracts. With a focus on value-based care, the position requires strong communication skills and healthcare acumen to influence decision-makers and enhance member care. Join a team dedicated to transforming lives through innovative solutions in the healthcare landscape.

Qualifications

• 5-8 years of experience in healthcare, with 2-4 years in health plan partnerships.
• Strong ability to influence decision-makers and translate discussions into opportunities.

Responsibilities

• Develop health plan partnerships and negotiate value-based contracts.
• Stay informed about regulations affecting health plan operations.

Skills

Healthcare Sector Experience

Interpersonal Skills

Communication Skills

Negotiation Skills

Relationship Building

Healthcare Acumen

Job description

Director, Health Plan Contracting

Location : Name Linked

Remote - US

ID

2025-6497

Job Locations

US-Remote

Category

Payer Contracting

Type

Regular Full-Time

Overview

At Groups, we change lives. Our care model ties our beliefs about the power of community and counseling with evidence-based medicine and supporting the holistic needs of those we serve. Today, as the largest value-based outpatient addiction treatment provider in the U.S., we bring care directly to those who need it, especially in communities that traditional providers overlook. We're proving that value-based care can thrive in the Medicaid population while achieving exceptional results at scale. Unlike traditional providers who are paid for the volume of services, we are paid for results - enabling us to expand treatment access while delivering remission and retention rates far above the national average.

Responsibilities

Groups is seeking a Director of Health Plan Contracting to support its expansion into new markets. Reporting to the Senior Vice President, Payer Partnerships, this role is responsible for:

Health Plan Partnership Development: Identify, outreach, and engage prospective health plan partners in key states
• Value Proposition: Clearly articulate Groups' unique value proposition to prospective health plans and tailor messaging to various audiences
• Deal Execution: Navigate matrixed organizations in service of negotiating value-based contracts that benefit Groups' plan partners, members, and organization
• Market Strategy: Integrate information on the regulatory environment, market dynamics, and organizational priorities in each state to create tailored partnership arrangements that expand member care.

Responsibilities

• Stay informed about national and state regulations and legislation affecting health plan operations in each market, and identify new states for potential expansion.
• Research and identify champions for value-based SUD care within health plans to begin contracting conversations
• Clearly articulate Groups' clinical model, outcomes, and value proposition to senior health plan executives, and lead discussions on Substance Use Disorder (SUD) needs.
• Partner with health plans to analyze data and pinpoint areas where Groups can provide added value.
• Manage the complete contracting process, from initial contact and presentation to negotiation and finalization, adapting to specific payer requirements.
• Collaborate with Partner Success to ensure health plans recognize and can articulate the value of Groups' care within their organizations.

Qualifications

• 5-8 years of experience in the healthcare sector, ideally with 2-4 years of experience partnering with or working at health plans.
• Outstanding interpersonal, communication, relationship-building, organizational, and time-management skills.
• Comfortable leading executive discussions and customizing content to individual stakeholders.
• Strong ability to influence decision-makers and translate discussions into commercial opportunities.
• Establishes credibility and rapport with both health plan and internal stakeholders.
• Strong healthcare acumen and knowledge of Medicaid and the health plan landscape.
• Willingness and ability to travel approximately 20%.

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