SVP, Payor Strategy

Axia Women's Health

United States

On-site

USD 250,000 - 450,000

Full time

5 days ago
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Job summary

Axia Women’s Health, the nation’s largest community-based women’s health network, seeks an executive to lead payor strategy for affiliated practices. You will shape multi-year plans across commercial, Medicare Advantage, and Medicaid programs, and oversee FFS and VBC contracting within the MSO framework.

Reporting to the Chief Growth Officer, you’ll collaborate with Revenue Cycle, Finance, and physician leadership to optimize reimbursement, expand in new markets, and drive strategic growth for a

Qualifications

  • Strategic payor leadership across multiple plans (FFS and VBC).
  • Strong contracting expertise within a physician-led network.
  • Ability to align clinical and financial goals across markets.

Responsibilities

  • Develop multi-year payor strategy across commercial, Medicare Advantage, and Medicaid plans.
  • Lead contracting for affiliated PCs within MSO, ensuring compliance with governance.

Skills

Payor strategy
Contracting
Value-based care
Leadership

Tools

MSO

Job description

Axia Women's Health is the nation's largest community-based, integrated women's health network, serving women throughout New Jersey, Pennsylvania, Indiana, and Kentucky. At its core, Axia Women's Health is a community of more than 400 providers across nearly 150 locations committed to delivering a more caring, connected, and progressive healthcare experience for women. Its rapidly growing network spans OB/GYN care, breast health, high-risk pregnancy care, urogynecology, behavioral health, fertility, imaging, and laboratory services. As a leading physician-led women's healthcare platform, Axia partners with affiliated physician practices to drive clinical excellence, operational performance, and sustainable growth. Together, Axia Women's Health puts women first by delivering the personalized care women need to lead healthier, happier lives. Axia Women's Health has been recognized as the #1 Physician Practice for Women's Health by Castle Connolly and certified as a Great Place to Work for five consecutive years. Learn more at www.axiawh.com.

The SVP, Payor Strategy leads payor contracting on behalf of Axia Women's Health 's affiliated physician practices across a growing multi-state MSO platform. Responsible for both fee-for-service (FFS) and value-based care (VBC) arrangements, this executive will develop and execute enterprise payor strategy across commercial, Medicare Advantage, and Medicaid managed care plans. Axia currently operates in New Jersey, Pennsylvania, Indiana, and Kentucky and continues to expand. Reporting to the Chief Growth Officer, the SVP will lead market expansion contracting efforts, support M&A activity from diligence through integration, and serve as a strategic advisor to executive leadership, Finance, Revenue Cycle, Operations, and physician leaders. The ideal candidate is a strategic and influential healthcare executive with deep expertise in provider contracting, reimbursement strategy, and payor negotiations, coupled with the ability to build strong relationships across physician, executive, and health plan stakeholders.

Essential Functions:
Payor Strategy
  • Develop and carry out a multi-year payor strategy across commercial, Medicare Advantage, and Medicaid managed care plans that supports Axia's growth and financial goals.
  • Lead contracting on behalf of the affiliated professional corporations (PCs) within the MSO model, in keeping with corporate practice of medicine requirements and Axia's governance structure.
  • Assess market dynamics, payor behavior, and competitive positioning in current and target markets to set contracting priorities.
Fee-for-Service Contract Optimization
  • Lead negotiations, renewals, and amendments of FFS agreements to improve rates, strengthen contract terms, and reduce administrative burden.
  • Build contract strategies for each service line, including professional, imaging, and laboratory fee schedules, and address prior authorization, site-of-service, and ancillary billing terms specific to each.
  • Manage escalations, disputes, and termination strategy when payor performance falls short of expectations.
  • Work with Revenue Cycle and Finance to monitor contract compliance, identify underpayments, and reduce reimbursement leakage.
Value-Based Care & Alternative Payment Models
  • Design, negotiate, and expand VBC arrangements, including quality incentive programs, shared savings, care management fees, and other alternative payment models suited to women's health.
  • Model the financial and operational impact of proposed arrangements and recommend which structures to pursue.
  • Partner with clinical and operational leaders to track performance against quality, utilization, and cost benchmarks and capture earned incentives.
Market Expansion & New Arrangements
  • Structure payor arrangements for new markets and new service lines, including network participation strategy, rate positioning, and contracting timelines.
  • Build relationships with health plan leadership in current and expansion markets.
M&A Support
  • Lead payor diligence on prospective practice acquisitions and affiliations in new markets, including contract review, rate benchmarking, assignment and change-of-control provisions, and reimbursement risk.
  • Partner with Revenue Cycle Management to guide payor onboarding of newly affiliated practices.
  • Provide reimbursement assumptions and synergy estimates to support deal modeling and integration planning.
Analytics, Reporting & Executive Partnership
  • Maintain payor performance scorecards covering rates, contract profitability, VBC performance, and denial trends.
  • Present findings and recommendations to the Chief Growth Officer, executive leadership, physician leadership, and the Board.
  • Monitor federal and state reimbursement policy, CMS rulemaking, and payor policy changes and advise on business implications.
Supervisory Responsibilities:

Manages a small team that supports contracting and payor analytics Skills Expert command of commercial, Medicare Advantage,

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