Director of Contracting

Carda health Inc.; United States; Remote; USD 90,000 - 150,000; Full time

Job summary

An established industry player is seeking a Director of Contracting to transform healthcare reimbursement strategies. This pivotal role involves leading the payor contracting strategy, negotiating high-value contracts, and ensuring network adequacy across states. The ideal candidate will have over 8 years of progressive experience in healthcare contracting, a robust network in the industry, and a knack for data-driven decision-making. Join a dynamic team dedicated to improving access to life-saving therapy and making a meaningful impact in the healthcare landscape. If you are a tenacious negotiator with a passion for healthcare, this opportunity is perfect for you.

Qualifications

• 8+ years of experience in healthcare contracting with major payor organizations.
• Strong understanding of reimbursement methodologies and telehealth regulations.

Responsibilities

• Lead payor contracting strategy to maximize coverage and optimize rates.
• Negotiate contracts with national and regional health plans and analyze market trends.

Skills

Negotiation Skills

Data-Driven Decision Making

Relationship Building

Healthcare Contracting Knowledge

Market Analysis

Education

Bachelor's Degree

Job description

About Carda

Rehab is a pain. So much so that only 10% of qualifying Cardiac and Pulmonary patients attend. At Carda Health, we’ve reimagined rehab. Our program allows patients to complete inspiring, convenient, life-saving therapy remotely.

Who are we?

We are a team of clinicians, data scientists, mathematicians and repeat entrepreneurs. And a few recovering financiers. Our belief is that technology and data, when applied to the right problem, transforms people’s lives and changes even the most entrenched industries. Carda was founded by Harry and Andrew, two friends from Wharton who share a family history of heart disease and experience with poor access to care. We now work with some of America’s largest and top-ranked hospitals and most innovative insurers. We are fortunate to be backed by some of the best investors in the business who have also backed the likes of Livongo, Hinge, Calm, MDLive, and others.

Who are you?

You are tenacious, driven, and want to make an impact. You have a proven track record of being a sharp negotiator who consistently achieves favorable contract terms. You enjoy developing and executing a comprehensive plan for improving our contracting. You’re a natural relationship builder with established industry connections and are able to explain complex contracting concepts to all levels of stakeholders. You are a data driven decision maker.

Position Overview:

The Director of Contracting will be responsible for developing and executing our payor contracting strategy as well as directly negotiating high-value contracts. The ideal candidate brings extensive experience from major health insurance organizations and maintains a robust network of industry relationships.

In a little more detail:

• Lead overall payor contracting strategy to maximize network coverage and optimize reimbursement rates
• Ensure network expansion and adequacy across all states
• Negotiate fee-for-service contracts with national and regional health plans, government programs, and other payors
• Analyze market dynamics, competitive positioning, and reimbursement trends to inform contracting strategy
• Build and maintain relationships with key decision-makers at major health plans and payor organizations
• Collaborate cross-functionally with Finance, Legal, Operations, and Clinical teams to ensure contracts align with organizational goals
• Report on contracting metrics, achievements, and opportunities to executive leadership

What we look for:

• 8+ years of progressive experience in healthcare contracting
• Proven track record at major payor organizations (e.g., UnitedHealthcare, Humana, Anthem, Cigna, Aetna)
• Demonstrated success negotiating favorable fee-for-service contract terms and rates
• Extensive knowledge of healthcare reimbursement methodologies, value-based care models, and telehealth regulations
• Strong understanding of CPT/HCPCS coding, Medicare fee schedules, and commercial rate structures
• Established network of industry contacts and relationships with key payor representatives
• Bachelor's degree preferred