Director Payor Partnerships and Network Operations

About Our Company

We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.

Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.

When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.

Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.

Job Description

The Director, Payor Partnerships and Network Operations will be a key leader within the organization partnering with internal and external teams to facilitate competitive pricing, YOY revenue growth and alignment with Enterprise revenue growth strategy.   

This role will be responsible for the financial analysis of all FFS and VBC contracts with national payors across various lines of business, including Commercial (employer and individual exchange), Medicare Advantage and Managed Medicaid.  The divisional scope of responsibility for this role will include Village MD, SMG, CityMD and Starling divisions.

In collaboration with VillageMD, SMG, CityMD and Starling Business leaders, respective Finance organizations, and Payor contractors, the Director will help establish performance targets both locally and at Enterprise level, annual budgets, and financial improvement strategies.

Key Responsibilities:

• Lead and manage a team inclusive of both internal and external resources, direct and matrixed resources, focused on driving revenue, margin, growth, and performance through detailed analysis of payor contracts.
• Develop and implement models to analyze reimbursement rates and identify opportunities for improvement.
• Advise senior leadership on financial strategies to optimize contract performance and profitability.
• Leverage data analytics, business insights, and cross-functional collaboration to drive operational and financial optimization.
• Analyze and interpret claim-level data, as well as broader trended metrics, to assess and communicate performance impacts to internal and external stakeholders.
• Build strong relationships with senior operations leadership to develop solutions for complex business issues.
• Support the development of monitoring FFS and VBC contract performance across multiple payers and lines of business.
• Implement strategies to ensure competitive FFS and VBC compensation in all markets, standardizing tools for contract performance prediction and revenue improvement.

Skills and Experience:

• Strong background in financial analysis and modeling, with expertise in revenue pipeline development, Enterprise growth strategy, annual strategy development and pricing development with payors.
• Extensive experience in leveraging data analytics and business insights to drive decisions and optimize financial performance.
• Demonstrated leadership in managing and mentoring teams in a matrixed, cross-functional environment.
• Advanced communication skills, with the ability to translate complex financial and operational data for diverse audiences.
• Strong project management experience, with a track record of successfully leading initiatives across multiple departments and stakeholders.
• Knowledge and experience in healthcare finance, actuarial modeling, and contracting methodology.
• Ability to think independently and develop new processes to enhance contract and financial performance.
• Strong in Excel, healthcare analytics, and contract modeling with a focus on cost and utilization drivers.

Qualifications:

• Bachelor’s degree in business, Healthcare Administration, or a related field
• Minimum of 5+ years in progressive roles within healthcare organizations.
• Demonstrated track record of success in a leadership role, driving change and improving financial and operational outcomes.

This is an exempt position. The base compensation range for this role is $120,800 to $160,000.  At VillageMD, compensation is based on several factors including but not limited to education, work experience, certifications, location, etc.  The selected candidate will be eligible for a valuable company benefits plan, including health insurance, dental insurance, life insurance, and access to a 401k plan.

About Our CommitmentTotal Rewards at VillageMD

Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families.  Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.

Equal Opportunity Employer

Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.

Safety Disclaimer

Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/.