Fractional VP, Managed Care & Payor Strategy

KPC Health, Inc.; Corona (CA); On-site; USD 132,000 - 182,000; Part time

Job summary

KPC Health, Inc. in Corona, CA seeks a Fractional/Contract VP Managed Care Contracting & Payor Strategy to lead development and execution of contracting strategies and payor relationships for a multi-hospital system.

This senior leader negotiates favorable terms with payors, drives revenue growth, and partners with CFO and executives across finance, legal, and operations. Ideal candidate has strong healthcare finance background, payor strategy expertise, and proven leadership.

Qualifications

• Bachelor's degree in healthcare administration, business, finance, or related field.
• 10+ years of experience in managed care contracting, payor strategy, or related field.
• Minimum of 5 years in a leadership role.
• Demonstrated success in negotiating and executing managed care contracts with payors.
• Strong understanding of healthcare finance, reimbursement models, and regulatory requirements.
• Excellent communication, negotiation, and relationship-building skills.
• Ability to work effectively with cross-functional teams and senior leadership.
• Knowledge of California healthcare market and payor landscape preferred.
• Deep understanding of CA managed care contracting and relationships including IPA’s; capitation/risk, safety net services and commercial managed care contracting
• Strategic Thinking
• Problem Solving
• Effective Communication

Responsibilities

• Develop and implement a comprehensive managed care contracting strategy to drive revenue growth and financial performance for the multi-hospital system.
• Lead negotiations with payors to secure favorable contract terms, rates, and reimbursement structures.
• Build and maintain strong relationships with payors to ensure successful contract negotiations and ongoing collaboration.
• Monitor and analyze market trends, payor policies, and reimbursement rates to identify opportunities for improved financial performance.
• Collaborate with internal stakeholders, including finance, legal, and operational teams, to develop and implement strategies to optimize managed care contracts and payor relationships.
• Provide leadership and guidance to a team of managed care contracting professionals to ensure successful contract negotiations and execution.
• Oversee the development of contract performance metrics and reporting to track progress and identify areas for improvement.
• Serve as a subject matter expert on managed care contracting and payor strategy, providing guidance and support to senior leadership and other stakeholders.
• Stay current on industry trends, regulations, and best practices related to managed care contracting and payor strategy.
• Represent the multi-hospital system in negotiations with payors, industry events, and other relevant forums to promote the organization's interests and objectives.

Skills

Negotiation

Leadership

Strategic thinking

Communication

Relationship building

Cross-functional teamwork

Healthcare finance

Regulatory knowledge

Problem solving

CA market knowledge

Education

Bachelor's degree

Master's degree preferred

Job description

KPC Health, Inc. in Corona, CA seeks a Fractional/Contract VP Managed Care Contracting & Payor Strategy to lead development and execution of contracting strategies and payor relationships for a multi-hospital system.

This senior leader negotiates favorable terms with payors, drives revenue growth, and partners with CFO and executives across finance, legal, and operations. Ideal candidate has strong healthcare finance background, payor strategy expertise, and proven leadership.