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Aledade

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Director, Payer Contracting (MA & Medicaid)

ArlingtonRemoteFull-time

AI Summary

Director focused on negotiating Medicare Advantage and Medicaid value-based contracts with national and regional payers, managing strategy, terms, and relationships to shift providers toward value-based care.

About this role

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.

    • Minimum 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.

    • Skills

    Contract Lifecycle ManagementCross-Functional CollaborationData Reporting And DashboardingHealth Plan Contract AnalyticsMA & Medicaid Contract Terms KnowledgeRegulatory/compliance AwarenessRisk-sharing And Multi-year ArrangementsStakeholder ManagementValue-based Contract Negotiation

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