Manager, Payer Strategy & Contracting

Job Summary We are seeking a Manager of Payer Strategy & Contracting to architect and execute our payer contracting strategy during a critical phase of organizational growth. This is a high-impact, externally facing role directly tied to revenue, margin, and scalability. The successful candidate will lead complex payer negotiations, design economically sound contract structures, and translate innovative care models into compelling payer value propositions. This role also serves as a strategic partner to senior leadership, ensuring payer agreements align with evolving care models, pricing strategy, and long-term margin goals. Essential Functions and Tasks Payer Strategy & Negotiation Lead end-to-end negotiation of payer agreements across fee-for-service (FFS), value-based, risk-bearing, and hybrid contract models Oversee development of negotiation materials including rate benchmarking, reimbursement trend analysis, and financial impact modeling. Drive rate optimization and structure contracts that improve contribution margin and support long-term scalability Leverage established payer relationships to accelerate deal cycles and unlock favorable reimbursement terms Review and interpret health plan contract language across payor, medical group/IPA, and hospital/ancillary contexts Apply working knowledge of the healthcare delivery system, IPA operations, managed care frameworks, and applicable healthcare law to develop contracting strategy Ensure payer contracts and fee schedules are accurately documented, maintained, and accessible. Build analytics tools and reporting that provide leadership with real-time visibility into payer performance and contract opportunities Deal Architecture & Financial Alignment Partner with Legal, Finance, and Service Delivery to align contract terms with unit economics, pricing strategy, and regulatory requirements Partner closely with Revenue Cycle, AR, and Billing teams to ensure contract terms are operationalized accurately within systems and workflows. Translate clinical programs — including virtual care, various modalities, and hospital-based professional settings into compelling, reimbursable contract models Ensure all agreements support enterprise goals around margin expansion and sustainable growth Cross-Functional Leadership Serve as the central integrator across Legal, Finance, Clinical, and Service Delivery functions to structure and close deals Provide clear, evidence-based guidance to internal stakeholders on contract tradeoffs, risks, financial impact, and strategic implications Build internal clarity on how payer market dynamics affect product design, pricing, and operational execution Support audit readiness and compliance with payer requirements, including documentation and contract interpretation guidance Market Intelligence & Relationship Management Maintain and deepen senior-level relationships with national and regional payers Surface actionable insights on payer priorities, reimbursement trends, and competitive positioning Position the organization as a credible, preferred strategic partner across key payor accounts Serve as a key point of contact for payor and physician client representatives, leading and participating in ongoing payer meetings, operational reviews, and strategic discussions with clients and payer partners Analytics & Performance Monitoring Analyze payor performance, reimbursement trends, denial patterns, and payment variances to identify strategic opportunities Develop payor and physician-client scorecards and KPIs to evaluate contract effectiveness and financial impact Build and maintain financial models to support contracting, re-contracting, and new market entry decisions Support value-based contract management including quality metric tracking, shared savings calculations, and incentive reconciliation Education and Experience Requirements Required 8–10+ years of experience in managed care contracting, with a demonstrated track record leading negotiations with national and regional health plans Proven ability to secure competitive reimbursement rates and structure complex agreements across FFS, value-based, and risk-based models Established strategic relationships with payor organizations at a senior level Deep understanding of reimbursement methodologies: PFS, RBRVS, capitation, bundled payments, shared savings Direct experience managing or supporting relationships with physician clients, medical groups, CINs, or IPAs on behalf of a provider organization Proficiency with financial modeling, contract performance analytics, and tools such as Excel, Tableau, or comparable platforms Strong organizational and time management skills Ability to operate in a fast-paced, collaborative environment High attention to detail in contract interpretation and execution Strong executive communication skills; ability to operate effectively at both leadership and operator levels Bachelor's degree in Healthcare Administration, Business, Finance, or a related field Preferred MBA or MHA Experience in virtual care, outpatient multi-site, or technology-enabled care delivery environments Familiarity with Medicaid, Medicare Advantage, and pediatric reimbursement structures Experience with contract management systems and knowledge of state and federal regulatory requirements (ACA, CHIP, network adequacy) Compensation Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons. This position is also eligible for a discretionary incentive bonus in accordance with company policies. Ventra Health Equal Employment Opportunity (Applicable only in the US) Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions. #J-18808-Ljbffr