The Director, Payer Contracting, MA & Medicaid on the Strategic Payer Partnerships team will execute Aledade's Medicare Advantage and Medicaid value-based care contracts with national and regional health plans as we help primary care providers shift into value-based care. The role will be focused on negotiating value-based care contracts with health plans for their Medicare Advantage and Medicaid members. This role will report to the VP, MA & Medicaid Contracting.
We are flexible with respect to geographic location, and the ideal candidate will be comfortable working remotely/work from home within the US or be based from Bethesda, MD office.
Primary Duties:Negotiation & Strategy:- Negotiate and renegotiate MA & Medicaid value-based care contracts with prospective payer partners
- Proactively engage with payer partners to set and/or improve contract terms
- Collaborate with Senior Leadership to qualify and source market growth and expansion for multi-year risk arrangements
Contract Management & Reporting:- Communicate with key, internal stakeholders to ensure a smooth and timely implementation of negotiated terms
- Read, draft contract language, and track deliverables to ensure compliance and consistency; Compile data and report updates
- Develop and maintain a deep knowledge of existing MA & Medicaid contract terms and act as the internal expert for contract questions
Relationship Management:- Build and manage relationships with payers and other key stakeholders to resolve issues, optimize performance, and identify new opportunities for collaboration.
Other duties as assignedMinimum Qualifications:- Bachelor's degree
- 12+ years in healthcare with health plans or provider groups working on contract negotiations within value-based care
- Results-oriented with the ability to exercise influence to achieve goals rather than control
- Proven track record of creating, maintaining, and enhancing relationships and communicating effectively with senior management
- Exceptional attention to detail in contractual language and processes
- Expert sales, business development, growth professional at local and national level
- Passionate about driving the shift from fee-for-service to value based care
Preferred Qualifications:- Master's degree or other advanced degrees in management, health services research, health and/or public policy, or other relevant fields
Physical Requirements:- Prolonged periods of sitting at a desk and working on a computer.
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options
And much more!
At Aledade, we don't just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work.
