Director, Payor Contracting & Value-Based Care

Central Ohio Primary Care; Westerville (OH); On-site; USD 120,000 - 170,000; Full time

Job summary

Central Ohio Primary Care in Westerville, OH is seeking a full-time Director, Payor Contracting to lead rate negotiations and manage payor relationships across commercial, Medicare Advantage, and Medicaid lines of business.

The role includes contract execution, implementation, quality control, auditing, and issue resolution to support accurate, competitive payor agreements and value-based contracts, partnering with clinical quality teams to align terms with organizational goals.

Qualifications

• Bachelor’s Degree required in business, finance, healthcare administration or related field.
• Minimum seven years’ progressive experience in payor contracting or managed care.
• Strong negotiation skills with track record of favorable terms with payors.

Responsibilities

• Lead end-to-end rate negotiations with commercial, Medicare Advantage, and Medicaid payors and finalize contract language.
• Review payor contracts and fee schedules for accuracy prior to execution and maintain contract repository.
• Monitor performance against VBC benchmarks and inform renegotiation strategy at renewal.
• Build financial models to evaluate rates and reimbursement terms against projected volumes.
• Provide regular updates on open issues and escalation timelines.

Skills

Negotiation

Financial modeling

Managed care contracting

Risk adjustment knowledge

Data analysis

Epic / claims systems

MS Excel

Education

Bachelor’s Degree in Business, Finance, Healthcare Administration or related discipline

Tools

Microsoft Office

Epic

Claims/Billing systems

Job description

Central Ohio Primary Care in Westerville, OH is seeking a full-time Director, Payor Contracting to lead rate negotiations and manage payor relationships across commercial, Medicare Advantage, and Medicaid lines of business.

The role includes contract execution, implementation, quality control, auditing, and issue resolution to support accurate, competitive payor agreements and value-based contracts, partnering with clinical quality teams to align terms with organizational goals.