Director, Payer Contracting (MA & Medicaid)

TL;DR

Director, Payer Contracting (MA & Medicaid): Executing Medicare Advantage and Medicaid value-based care contracts with national and regional health plans with an accent on strategic negotiations and payer partnerships. Focus on driving the shift from fee-for-service to value-based care and managing multi-year risk arrangements.

Location: Must be based in the United States (Remote or hybrid from Bethesda, MD office)

Company

hirify.global is a public benefit corporation that empowers independent primary care providers to thrive in value-based care models.

What you will do

• Negotiate and renegotiate MA & Medicaid value-based care contracts with prospective payer partners.
• Proactively engage with payer partners to set and improve contract terms.
• Collaborate with Senior Leadership to qualify and source market growth for multi-year risk arrangements.
• Draft contract language and track deliverables to ensure compliance and consistency.
• Develop and maintain expert knowledge of existing MA & Medicaid contract terms.
• Build and manage relationships with payers to resolve issues and identify new collaboration opportunities.

Requirements

• Bachelor’s degree.
• 12+ years in healthcare working on value-based care contract negotiations with health plans or provider groups.
• Proven track record of communicating effectively with senior management.
• Expertise in sales, business development, and growth at local and national levels.
• Must be based in the United States.

Nice to have

• Master’s degree or advanced degree in management, health services research, health/public policy, or related fields.

Culture & Benefits

• Remote-first culture with flexible work schedules.
• Comprehensive health, dental, and vision insurance (paid up to 80%).
• Generous time-off plan including 21 days of PTO in the first year and 11 paid holidays.
• 12 weeks of paid parental leave for all new parents.
• 401(k) with up to 4% match and stock options.
• Six weeks paid sabbatical after six years of service.