Head of Payer Network

VAXCARE LLC; United States; À distance; USD 220 000 - 340 000; Plein temps

Résumé du poste

VaxCare is seeking a strategic Head of National Payer Network & Value-Based Care Strategy to lead enterprise payer relations, national contracting, and reimbursement optimization. This remote executive role reports to the Chief Revenue Officer and drives initiatives across Commercial, Medicare Advantage, Medicaid, PBMs, IPAs, CINs, and ACOs to expand patient access and provider participation.

The ideal candidate will combine deep managed care expertise with payer economics, network strategy, and

Qualifications

• Experience contracting with primary care groups in value-based care constructs.
• Established rolodex of national and regional payer relationships.
• Willingness to travel 50–75% of the time.

Responsabilités

• Lead national payer contracting across commercial, Medicare Advantage, Medicaid, PBMs and regional plans.
• Develop scalable contracting frameworks for vaccines and therapies.
• Drive payer expansion into new markets and closed-network environments.
• Establish preferred payer and provider relationships and optimize contract performance.
• Design and execute national value-based care strategy and programs.

Connaissances

Payer relationships

Contract negotiations

Value-based care

Payer contracting

Market access

Travel flexibility

Description du poste

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Head of Payer Network

Full Time US

Head of National Payer Network & Value-Based Care Strategy

JOB DESCRIPTION

Job Title: Head of National Payer Network & Value-Based Care Strategy

Position Type: Full Time

Location: Open

Reports to: Chief Revenue Officer

ABOUT VAXCARE

Founded in 2008, VaxCare's mission is to remove operational, financial, and administrative barriers that limit vaccine access and adoption. Through its end-to-end care delivery platform, VaxCare enables physician practices, health systems, and other healthcare organizations to offer comprehensive immunization programs without inventory risk, operational burden, or reimbursement complexity. By managing vaccine procurement, inventory, compliance, and billing, VaxCare allows providers to focus on patient care while expanding access to life‑saving vaccines.

After more than a decade of disciplined execution and continuous innovation, VaxCare partners with over 5,000 providers and has become one of the Top 10 buyers‑and‑billers of vaccines in the nation. The company has grown well beyond its original vision and is now entering its next phase of scaled expansion.

Today, VaxCare partners with a broad and growing base of independent practices and health systems nationwide. The company is entering a pivotal phase of growth, with a clear ambition to scale revenue from approximately $730M in 2025 to $2B by 2029, driven by deeper penetration of existing markets, scaled expansion within community and regional health systems, and the introduction of new commercial offerings.

In June 2025, Blackstone acquired VaxCare and is committed to supporting the organization through this next phase of growth. Blackstone is a private equity firm based in New York. The firm seeks to invest in real estate, public debt, private equity, infrastructure, life sciences, growth equity, opportunistic, non‑investment grade credit, real assets, and secondary funds. This firm is a Registered Investment Adviser (RIA).

VaxCare remains founder‑led under Casey DeLoach. The culture reflects a strong sense of ownership, urgency, and belief in purpose. The organization values humility, learning, adaptability, and a deep sense of care for team members and customers alike. This “VaxCare‑ness” reflects a commitment to developing people professionally and personally, operating with intellectual humility, and building something larger than any individual contributor. The pace is fast, expectations are high, and leaders are expected to combine ambition with emotional intelligence and stewardship.

THE POSITION

The role will initially report to Founder and Chief Executive Officer Casey DeLoach—with the expectation that this role will report to the President or Chief Revenue Officer upon their hire as VaxCare's commercial organization scales—the Head of National Payer Network & Value-Based Care Strategy is responsible for leading VaxCare's enterprise payer strategy, national contracting efforts, reimbursement optimization initiatives, and value-based care partnerships. This executive will develop and execute strategies that expand patient access, increase provider participation, improve reimbursement performance, and position VaxCare as the preferred partner for payers seeking to improve vaccination, preventive care, and physician‑administered therapy outcomes. This is a remote‑based position.

This role serves as VaxCare's senior executive for payer engagement, contracting innovation, network strategy, and value-based program development across Commercial, Medicare Advantage, Medicaid, PBMs, IPAs, CINs, ACOs, and employer-sponsored health plans.

The successful candidate will combine deep managed care expertise, healthcare economics, provider network strategy, and value-based care leadership to accelerate VaxCare's evolution from a vaccine management platform to a national care delivery platform. VaxCare currently supports one of the nation's largest vaccination networks with more than 20 million patients, 33,000+ providers, 6,000+ clinics, and 600+ payer relationships.

Healthcare reimbursement is increasingly shifting toward outcomes, access, quality, and total cost-of-care performance. VaxCare possesses a unique combination of clinical, claims, adherence, and provider network data that creates opportunities to develop innovative payer partnerships focused on:

• Risk-based population health initiatives
• Women's health and LARC programs
• Provider incentive programs

This executive will build the strategy, partnerships, contracts, and market capabilities necessary to unlock that opportunity.

ESSENTIAL RESPONSIBILITIES

National Payer Contracting Leadership

• Responsible for the oversight, management, and development of 500-600 payer contracts to date.
• Own enterprise-wide payer contracting strategy across commercial, Medicare Advantage, Medicaid, PBMs, and regional health plans.
• Lead negotiation of national and regional payer contracts.
• Develop scalable contracting frameworks for vaccines, LARCs, and future physician‑administered therapies.
• Drive payer expansion into new markets and closed‑network environments.
• Establish preferred payer and preferred provider relationships.
• Optimize reimbursement economics and contract performance across all payer segments.
• Lead contract renewals, renegotiations, and strategic contract restructuring.
• Opportunity to build a small, dedicated team: assess current FTEs focused on this effort to determine fit for purpose and identify what other team members and skill sets are needed.

Value-Based Care Strategy

• Design and execute VaxCare's national value-based care strategy.
• Identify opportunities for risk-sharing, incentive-based reimbursement, and outcomes-driven programs.
• Develop payer offerings tied to:
• Preventive care adherence
• Quality measure performance
• HEDIS and STAR measures
• Build innovative reimbursement models that reward providers for closing care gaps.
• Develop scalable economic models demonstrating VaxCare's value to payers.

Strategic Payer Partnerships

• Build executive-level relationships with national payer leadership.
• Mature and/or establish partnerships with UnitedHealthcare, Elevance, Aetna, Cigna, Humana, Centene, Molina, Regional Blues plans.
• Create strategic joint-business plans with key accounts.
• Develop executive engagement forums and payer advisory councils.
• Serve as VaxCare's executive spokesperson for payer and market access initiatives.
• Partner with Payer Operations, Revenue Cycle Management (RCM), and Sales/Growth teams to expand payer access.
• Will work hand‑in‑hand with the Payer Operations and RCM leader to align contracting strategy with day‑to‑day operational execution.
• Developing and executing a targeted IPA engagement model tailored to California market dynamics.
• Ensuring sufficient provider access and patient coverage to support VaxCare's SAM and SOM objectives.
• Partnering closely with the physician sales team to navigate independent practice dynamics, IPA decision‑making structures, and local market access complexities.
• Lead strategies involving IPAs, CINs, ACOs, Delegated networks, Risk‑bearing entities
• Develop market‑entry strategies for difficult reimbursement environments.
• Drive network adequacy and payer participation initiatives.
• Create scalable contracting playbooks for new states and products.

Economic & Analytics Leadership

• Define and monitor enterprise payer KPIs.
• Develop reimbursement and profitability analytics in concert with VaxCare finance.
• Quantify payer‑specific value generated through:
• Increased vaccination rates
• Reduced care gaps
• Improved adherence
• Reduced avoidable medical costs
• Utilize claims, quality, and operational data to support contracting negotiations.

Key Performance Indicators

• Improve average reimbursement rate across the existing contract base.
• Manage and decrease issue‑resolution time with payers through developing a process to measure the current state and implementing a plan to reduce the # of issues and time to closure.
• Establish Joint Operating Committees (JOC) with top payers to build relationships, build proactive communication ahead of Network issues, and develop strategies to grow revenue.
• Contract with new payers where gaps in VaxCare's network exist.

REQUIRED EXPERIENCE & QUALIFICATIONS

VaxCare is seeking a seasoned payer contracting and value‑based care executive with a demonstrated ability to build and scale enterprise payer relationships. The ideal candidate will bring:

• An established rolodex of national and regional payer relationships.
• Experience contracting with Primary Care Physician Groups in value‑based care constructs.
• Experience with risk‑bearing entities (e.g., Aledade, Wellvana, Privia Health, and similar organizations) is a plus.
• Located ideally on the East Coast with willingness to travel 50‑75% of the time.

The ability to create and articulate an inspiring vision for the organization, not only for the areas they are directly responsible for, but the enterprise as a whole. The inclination to seek and analyze data from a variety of sources to support decisions and to align others with the organization's overall strategy. An entrepreneurial and creative approach to developing new, innovative ideas that will stretch the organization and push the boundaries within the industry. The ability to effectively balance the desire/need for broad change with an understanding of how much change the organization is capable of handling, to create realistic goals and implementation plans that are achievable and successful.

Executing for Results

The ability to set clear and challenging goals while committing the organization to improved performance; tenacious and accountable in driving results. Comfortable with ambiguity and uncertainty; the ability to adapt nimbly and lead others through complex situations. A risk‑taker who seeks data and input from others to foresee possible threats or unintended circumstances from decisions; someone who takes smart risks. A leader who is viewed by others as having a high degree of integrity and forethought in their approach to making decisions; the ability to act in a transparent and consistent manner while always taking into account what is best for the organization.

Leading Teams

The ability to attract and recruit top talent, motivate the team, delegate effectively, celebrate diversity within the team, and manage performance; widely viewed as a strong developer of others. The ability to persevere in the face of challenges and exhibit a steadfast resolve and relentless commitment to higher standards, which commands respect from followers. A leader who is self‑reflective and aware of their own limitations; leads by example and drives the organization's performance with an attitude of continuous improvement by being open to feedback and self‑improvement.

Relationships and Influence

Naturally connects and builds strong relationships with others, demonstrating strong emotional intelligence and an ability to communicate clearly and persuasively. An ability to inspire trust and followership in others through compelling influence, powerful charisma, passion in their beliefs, and active drive. Encourages others to share the spotlight and visibly celebrates and supports the success of the team. Creates a sense of purpose/meaning for the team that generates followership beyond their own personality and engages others to the greater purpose for the organization as a whole.

Driving Sustainability

Firmly believes that both sustainability and profit are in the organization's best long‑term interest. Integrates economic, societal, and environmental factors into a purpose‑driven strategy, turning sustainability into a competitive advantage. Understands and incorporates viewpoints from all key stakeholders to drive decision making and share the benefits. Delivers breakthrough innovations and business models that create value for all stakeholders, continually challenging traditional approaches. Sets audacious business and sustainability goals, driving concerted action and investments, and stays the course in the face of setbacks or push‑back from short‑term oriented stakeholders.

COMPETENCIES: Core to all positions at VaxCare

We Live (and Work) by Our Values:

• Building a team culture founded on trust, collaboration, and delivery excellence
• Belief in Something Bigger than Ourselves – Capacity to derive meaning from a larger purpose
• Humility as a Posture of Learning – Burning curiosity to learn without ego
• Adaptability & Embracing Change – Nimbleness & ready to seize new opportunities

Additional Must Haves:

• Dependability – Must be able to meet deadlines, work independently, maintain focus, & punctual
• Interpersonal Skills – Builds strong relationships & contributes to a positive work environment.
• Computer Skills – Skilled with computers, learns new tools quickly.
• Ethics – Honest, accountable, maintains confidentiality.