Director, Payer Strategy & Value-Based Contracts

CommUnityCare Health Centers; Austin (TX); On-site; USD 150,000 - 230,000; Full time

Job summary

CommUnityCare Health Centers is seeking a strategic Director, Payer Strategy & Contracting to lead development, negotiation, implementation, and management of payer agreements across Medicaid, Medicare, MCOs, and commercial payers.

You will partner with executive leadership and cross-functional teams to evaluate performance, model financial scenarios, mitigate risk, and drive continuous improvement in reimbursement strategy and contract operations.

Qualifications

• Bachelor's degree in Business, Healthcare Administration, Finance, or related field.
• 7 years of progressive experience in payer contracting within healthcare.
• 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.
• Evaluates terms related to reimbursement methodologies, payment policies and performance expectations.
• Designs, negotiates, implements and monitors value-based care arrangements.
• Models risk corridors, attribution and performance measures with cross-functional teams.
• Partners with Finance to forecast revenue and assess reimbursement performance.

Skills

Negotiation

Financial modeling

Data analysis

Operational readiness

Risk assessment

Leadership

Stakeholder management

Education

Bachelor's degree

Job description

CommUnityCare Health Centers is seeking a strategic Director, Payer Strategy & Contracting to lead development, negotiation, implementation, and management of payer agreements across Medicaid, Medicare, MCOs, and commercial payers.

You will partner with executive leadership and cross-functional teams to evaluate performance, model financial scenarios, mitigate risk, and drive continuous improvement in reimbursement strategy and contract operations.