Director, Payer Strategy & Value-Based Contracting

communitycare-centralhealth; Kramer (ND); On-site; USD 140,000 - 220,000; Full time

Job summary

CommunityCare-CentralHealth seeks a seasoned Director of Payer Strategy & Contracting to lead the development, negotiation, and management of payer agreements across Medicaid, Medicare, MCOs, and commercial payers.

You will collaborate with Finance, Revenue Cycle, Population Health, and Analytics to optimize reimbursement, model financial scenarios, and ensure regulatory compliance while driving performance improvements across fee-for-service and value-based models.

Qualifications

• Bachelor's Degree in Business, Healthcare Administration, Finance, or related field.
• 7 years of progressive experience in payer contracting within healthcare.
• Proven experience negotiating with Medicaid, Medicare, MCOs, and commercial payers.
• Experience structuring or managing value-based care arrangements or alternative payment models.

Responsibilities

• Leads payer contracting strategy, negotiations, renewals, amendments, and escalations with Medicaid, Medicare, MCOs, and commercial payers.
• Develops contracting strategies that support organizational priorities and maximize reimbursement.
• Evaluates contract terms related to reimbursement methodologies, payment policies, and performance requirements.
• Leads rate negotiations and recommends contract structures that balance financial and operational goals.
• Ensures payer agreements comply with federal, state, and program-specific requirements.
• Designs, negotiates, and monitors value-based care arrangements and associated proposals.
• Models risk corridors and performance measures with cross-functional teams.
• Prepares contract performance updates and supports executive decision-making.

Skills

Payer contracting

Negotiation

Healthcare finance

Regulatory compliance

Cross-functional leadership

Education

Bachelor's degree in Business/Healthcare Administration/Finance

Job description

CommunityCare-CentralHealth seeks a seasoned Director of Payer Strategy & Contracting to lead the development, negotiation, and management of payer agreements across Medicaid, Medicare, MCOs, and commercial payers.

You will collaborate with Finance, Revenue Cycle, Population Health, and Analytics to optimize reimbursement, model financial scenarios, and ensure regulatory compliance while driving performance improvements across fee-for-service and value-based models.