VP, Operations-Payor Partnerships

Starling Physicians; United States; Remote; USD 220,000 - 281,000; Full time

Job summary

Join a forward-thinking healthcare organization as the Vice President of Operations, Payor Partnerships. In this pivotal role, you'll drive operational excellence and strategic growth while overseeing payor contracts and fostering relationships with national partners. Your expertise in value-based care and fee-for-service agreements will be crucial as you collaborate across teams to ensure high-quality, cost-effective healthcare delivery. If you're passionate about innovation and excellence in healthcare, this opportunity will allow you to shape the future of care across multiple markets.

Benefits

Health Insurance

Dental Insurance

Life Insurance

401k Plan

Disability Coverage

Vision Coverage

Qualifications

• 20+ years in progressive healthcare roles required.
• Demonstrated analytical and project management skills.

Responsibilities

• Drive operational excellence and strategic growth in healthcare services.
• Manage relationships with national payor partners for collaboration.

Skills

Proactive Initiative

Collaborative Relationship Building

Understanding of Medical Cost Trends

Navigating Ambiguity

Medicare Advantage Bid Process

Health Plan Network Operations

Education

Bachelor's Degree in Business

Tools

Excel

PowerPoint

Word

Job description

About Our Company

We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.

Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes, and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.

When you join our team, you become part of a compassionate community dedicated to improving health care for all. We are innovating value-based care and leveraging integrated applications, population insights, and staffing expertise to ensure all patients have access to high-quality, connected care services that lead to better outcomes at a reduced total cost of care.

Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.

Job Description

Village Medical is seeking a dynamic and experienced Vice President of Operations, Payor Partnerships to join our Enterprise team. The VP of Operations will play a critical role in driving operational excellence, strategic growth, and the delivery of high-quality, cost-effective healthcare services.

This role is responsible for developing and implementing both value-based care (VBC) and fee-for-service (FFS) agreements aligned with the VillageMD business model to support profitable growth. The individual will lead a team responsible for operational implementation and oversight of payor contracts, including post-execution activities like contract and rate load, document retention, and high-level reporting on contract status and key terms. Additionally, in partnership with Revenue Cycle Management, they will oversee credentialing processes and related payor interactions. Building and maintaining strong relationships with national payor partners to ensure collaboration and strategic alignment is also key.

The role involves collaboration with Finance and operational leaders to meet performance targets, budgets, and financial strategies.

Key Responsibilities

• Operate effectively in a highly integrated, matrix environment, consulting with colleagues and recommending strategic and tactical actions.
• Ensure compliance with regulations, industry trends, and applicable laws to maintain operational and financial effectiveness.
• Develop and maintain standards for the payor contracting department.
• Design and implement contract structures and reimbursement rates for various providers.
• Partner with Business Unit Leadership to manage third-party service delivery networks.
• Collaborate with Operations to optimize provider support processes.
• Build strong relationships with payor organizations to advance innovative reimbursement models supporting quality and affordability.
• Leverage data analytics and cross-functional collaboration for operational and financial optimization.
• Oversee Credentialing and Payor Enrollment processes, serving on relevant committees.
• Support Market leaders in Roster Management oversight.
• Lead audit processes for Credentialing, Payor Enrollment, and Roster Management, and develop improvement plans.
• Monitor vendor performance related to credentialing and enrollment.
• Support resolution of payer issues with Revenue Cycle Management.
• Implement FFS fee schedules and manage Contract Management System.
• Provide internal education on payor contracting, regulatory changes, and methodologies.
• Maintain PADU guidelines and ensure contract provisions align with company goals and compliance.
• Support legislative, regulatory, and market insights to optimize payor agreements.
• Manage strategic relationships with national payor partners to ensure alignment and collaboration.

If you are a strategic healthcare leader passionate about innovation and excellence, we invite you to join us and help shape the future of healthcare across our VillageMD markets nationwide.

Skills for Success

• Proactive with strong initiative, highly organized, and detail-oriented.
• Skilled in building collaborative payor relationships for advantageous contracts.
• Understanding of medical cost trends affecting risk pools.
• Comfortable navigating ambiguity with a service orientation and humility.
• Knowledge of Medicare Advantage bid processes and health plan network operations (preferred).

Experience to Drive Change

• Proven ability to build strong relationships with operational leaders and payor partners.
• Bachelor’s degree required; focus in Business preferred.
• 20+ years in progressive roles, demonstrating leadership and analytical skills.
• Experience with healthcare reimbursement, modeling payor contracts, and value-based contracts.
• Strong organizational skills, multi-tasking ability, and proficiency in Excel, PowerPoint, and Word.

This is an exempt position with a base salary range of $220,800 to $280,100. Compensation depends on various factors including education, experience, certifications, and location. Benefits include health insurance, dental, life insurance, and a 401k plan.

Our Commitment

Total Rewards at VillageMD: Our team values health and wellness, offering benefits such as Medical, Dental, Life, Disability, Vision, FSA, and 401k.

Equal Opportunity Employer

We provide equal employment opportunities to all employees and applicants, regardless of protected characteristics.

Safety Disclaimer

We prioritize safety and do not use chat rooms or unsecure email for job communications. Be cautious of scams. For info, visit https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/.