Director, Payer Contracting (MA & Medicaid)

Aledade PBC; United States; Remote; USD 180,000 - 240,000; Full time

Benefits offered by this job

Health insurance

401(k) with match

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Job summary

Aledade is seeking a Director, Payer Contracting for the Strategic Payer Partnerships team. The role negotiates MA and Medicaid value-based care contracts with national and regional health plans, helping primary care providers shift into value-based care.

Remote-friendly within the United States or based in Bethesda, MD. Reports to the VP, MA & Medicaid Contracting, focusing on negotiation, contract management, and relationship strategies across payers.

Qualifications

• 12+ years in healthcare with health plans or provider groups working on contract negotiations within value-based care.
• Strong track record of creating, maintaining and enhancing relationships with senior management.
• Proven ability to influence to achieve goals rather than control.

Responsibilities

• Negotiate and renegotiate MA & Medicaid value-based care contracts with prospective payer partners.
• Proactively engage with payer partners to set or improve contract terms.
• Collaborate with senior leadership to qualify and source market growth for multi-year risk arrangements.
• Read, draft contract language and track deliverables to ensure compliance and timely implementation.
• Develop and maintain deep knowledge of MA & Medicaid contracts and act as internal expert.

Skills

Contract negotiations

Relationship management

Sales & business development

Influence without authority

Attention to detail

Strategic thinking

Education

Bachelor’s degree

Master’s degree or advanced degree

Job description

The Director, Payer Contracting, MA & Medicaid on the Strategic Payer Partnerships team will execute Aledade’s Medicare Advantage and Medicaid value-based care contracts with national and regional health plans as we help primary care providers shift into value-based care. The role will be focused on negotiating value-based care contracts with health plans for their Medicare Advantage and Medicaid members. This role will report to the VP, MA & Medicaid Contracting.

We are flexible with respect to geographic location, and the ideal candidate will be comfortable working remotely/work from home within the US or be based from Bethesda, MD office.

Primary Duties:

Negotiation & Strategy:

• Negotiate and renegotiate MA & Medicaid value-based care contracts with prospective payer partners
• Proactively engage with payer partners to set and/or improve contract terms
• Collaborate with Senior Leadership to qualify and source market growth and expansion for multi-year risk arrangements

Contract Management & Reporting:

• Communicate with key, internal stakeholders to ensure a smooth and timely implementation of negotiated terms
• Read, draft contract language, and track deliverables to ensure compliance and consistency; Compile data and report updates
• Develop and maintain a deep knowledge of existing MA & Medicaid contract terms and act as the internal expert for contract questions

Relationship Management:

• Build and manage relationships with payers and other key stakeholders to resolve issues, optimize performance, and identify new opportunities for collaboration.

Minimum Qualifications:

• Bachelor’s degree
• 12+ years in healthcare with health plans or provider groups working on contract negotiations within value-based care
• Results-oriented with the ability to exercise influence to achieve goals rather than control
• Proven track record of creating, maintaining, and enhancing relationships and communicating effectively with senior management
• Exceptional attention to detail in contractual language and processes
• Expert sales, business development, growth professional at local and national level
• Passionate about driving the shift from fee-for-service to value based care

Preferred Qualifications:

• Master’s degree or other advanced degrees in management, health services research, health and/or public policy, or other relevant fields

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.

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Who We Are:

Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we’ve become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you’re eager to join a collaborative, inclusive and remote-first culture - you’ve come to the right place.

What Does This Mean for You?

At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.

In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:

Flexible work schedules and the ability to work remotely are available for many roles

Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners

Robust time-off plan (21 days of PTO in your first year)

Two paid volunteer days and 11 paid holidays

12 weeks paid parental leave for all new parents

Six weeks paid sabbatical after six years of service

Educational Assistant Program and Clinical Employee Reimbursement Program

401(k) with up to 4% match

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And much more!

At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.

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