Manager, Payer Strategy – Contracting

Role Overview

• architect and execute our payer contracting strategy during a critical phase of organizational growth
• lead complex payer negotiations, design economically sound contract structures, and translate innovative care models into compelling payer value propositions
• serve as a strategic partner to senior leadership, ensuring payer agreements align with evolving care models, pricing strategy, and long-term margin goals
• 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
• 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
• 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
• 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

Requirements

• 8–10+ years of experience in managed care contracting
• 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

Tech Stack

• Tableau

Benefits

• eligible for our Ventra performance-based incentive plan
• help Us Grow Our Dream Team — Join Us, Refer a Friend, and Earn a Referral Bonus!