Vice President, Payor

Location: Basking Ridge, NJ preferred; remote locations will be considered; Hybrid

Supervisor/Reportingto: Chief Commercial Officer (CCO)

Status: Exempt

Department: Commercial/ Payor Relations

Travel: Up to 25%, including clinic markets and payer/vendor meetings

Job Purpose:
The Vice President, Payer leads the organization's payer contracting, network strategy, and market access agenda across a rapidly growing, multi-state fertility platform. This role owns the full payer relationship lifecycle - from contracting and reimbursement strategy through credentialing oversight and new benefit product market access - and serves as the organization's primary voice with national and regional payers, fertility benefit administrators, and employer-sponsored benefit programs. The VP, Payer will bring order to a complex, multi-EIN contracting landscape shaped by acquisition history, while positioning the organization to capture growth from expanding state infertility mandates and the rise of employer-purchased fertility benefits.

Essential Functions and Accountabilities:
Payer Contracting & Network Strategy

• Own end-to-end payer contracting strategy across all markets, including rate negotiation, contract language, and renewal cycles.
• Rationalize and harmonize payer contracts and reimbursement terms across legacy entities acquired through M&A, working toward consistent, defensible rate structures.
• Build and maintain a payer contracting playbook, including model contract terms, escalation paths, and a centralized contract repository.
• Lead value-based and alternative payment model exploration where appropriate to the fertility benefit landscape.

Market Access & Payer Relations

• Serve as the primary relationship owner for national payers, regional health plans, and fertility benefit administrators (e.g., Progyny, Carrot, Maven, WIN).
• Lead market access strategy for new and expanding employer-sponsored fertility benefit products, positioning the organization as a preferred provider.
• Track and respond to state infertility mandate developments, ensuring the organization is positioned to capture in-network growth as coverage expands.
• Represent the organization at payer, employer benefits, and industry conferences to build visibility and strategic relationships.

Cross-Functional & Operational Leadership

• Partner with Revenue Cycle, Legal, and Clinical Operations to ensure contract terms translate cleanly into billing, prior authorization, and reimbursement workflows.
• Oversee payer-facing credentialing strategy in partnership with credentialing operations to minimize onboarding delays for new providers and acquired clinics.
• Support integration of newly acquired practices into the organization's payer contracting and benefit administrator relationships.
• Provide regular payer landscape reporting and contracting performance metrics to the CCO and executive leadership.

PE / Board Reporting

• Develop board- and investor-ready materials summarizing payer mix, contracting wins, reimbursement trends, and market access progress.
• Quantify the financial impact of contracting initiatives to support enterprise value creation narratives.

Qualifications

Required

• 8+ years of progressive experience in payer contracting, managed care, or market access, including direct payer negotiation experience.
• Experience operating across multiple states and multiple legal entities/EINs in a multi-site healthcare environment.
• Demonstrated success negotiating and managing contracts with national payers and/or specialty benefit administrators.
• Strong understanding of healthcare reimbursement methodologies, credentialing fundamentals, and revenue cycle interdependencies.
• Bachelor's degree in healthcare administration, business, or related field.

Preferred

• Direct experience in fertility, women's health, or another high-growth specialty care segment.
• Experience in a private equity-backed or M&A-intensive healthcare organization.
• Familiarity with fertility benefit administrators and employer-purchased fertility benefit design.
• MBA or advanced degree.

Skills and Competencies

• Expert-level negotiation skills with the ability to balance organizational economics against payer relationship durability.
• Strong financial and data fluency; comfortable building and defending rate models and contracting ROI analyses.
• Exceptional relationship-building skills across payer, employer, and internal operational stakeholders.
• Comfortable operating with ambiguity and building structure from a fragmented, acquisition-driven starting point.
• Polished executive communication and presence; credible in payer C-suite and board settings alike.

Leadership Profile

This role suits a builder - someone energized by creating structure where none exists, who can move fluidly between detailed contract negotiation and high-level strategic positioning. The ideal leader brings a collaborative, low-ego style that earns trust quickly with clinical operators, payers, and the executive team, while holding a firm, well-prepared line at the negotiating table. They will be comfortable as the face of the organization externally and a hands-on operator internally.

Impact

Within the first year, success looks like a rationalized, well-documented payer contracting infrastructure; measurable improvement in reimbursement rates and contract terms across legacy entities; expanded in-network and benefit-administrator relationships that drive patient volume growth; and a credible, quantified payer strategy narrative for board and PE sponsor reporting.

IVI-RMA offers a comprehensive benefits package to all employees who work a minimum of 30 hours per week.

• Medical, Dental, Vision Insurance Options
• Retirement 401K Plan
• Paid Time Off & Paid Holidays
• Company Paid: Life Insurance & Long-Term Disability & AD&D
• Flexible Spending Accounts
• Employee Assistance Program
• Tuition Reimbursement