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.

Job Description

Join VillageMD as SVP, Summit Health Payor Partnerships and Contracting.

Could this be you?

Integral to our team, the SVP of Payor Partnerships and Contracting will be accountable for creating a strategy that defines our approach to payor partners across the business unit. This leader will be critical to driving successful payor partnerships through development and execution of agreements that support our business model, particularly our physician partners and patients served. This individual will be responsible for both leading and supporting payor negotiations with an emphasis on building strong, collaborative payor relationships that support innovative reimbursement structures to advance the best interest of high quality, affordable patient care.

How you can make a difference

• Provide strategic thought leadership to Summit Health and CityMD business unit Presidents and leadership teams regarding value-based and fee-for-service contracting initiatives. These responsibilities need to be carried out with a high value placed on process buy-in, needs and reactions of constituencies, consensus, and expectation management
• Lead all the commercial and government contracting functions for the business unit, and will be responsible for continued development of a portfolio contracting strategy that will support the growth and profitability of the organization
• Develop scalable team structure with regional leverage that manages local and state level health plan relationships
• Working with the Chief Commercial Officer and business unit Presidents, establish the department's strategic vision, objectives, and policies and procedures
• Lead the negotiation of complex, value-based payor agreements, and ownership over the strategic development and oversight of provider contracting
• Provide input to business unit leadership and other stakeholders relative to business development and strategic positioning as it relates to payor strategy
• Advise the business unit executive team on emerging trends and methodologies in managed care contracting, payor relations and legal issues
• Pursue and develop relationships with payors and employers with regard to new payment models that support the strategic goals of the enterprise.
• Monitor relevant policy at a state and national level and assess opportunities and threats related to emerging and evolving issues
• Operate effectively in a highly integrated, matrix environment where s/he will regularly consult with colleagues and recommend plans of actions on a broad range of strategic and tactical initiatives.
• Apply current knowledge and understanding of regulations, industry trends, current best practices, new developments, and applicable laws to ensure operational and financial effectiveness. Partners to ensure regulatory compliance for all areas of responsibility
• Develop, implement, and maintain production and quality standards for the payor contracting department
• Develop and implement the contract structures and reimbursement methods and rates for all professional, institutional, ancillary and vendor providers
• Partner with Business Unit Leadership to design, execute, and manage third party service delivery network
• Work closely with Operations team members to ensure that key provider support processes are optimized
• Negotiate and improve upon stop loss provisions
• Improve deal terms for quality measures
• Partner and participate in business development efforts and initial outreach for expansion
• Form strong, collaborative, working relationships across multiple payor organizations to advance innovative reimbursement arrangements that support advancement of quality and affordability of care

Skills for success

• Ability to be proactive with strong personal initiative as well as highly organized and detail oriented
• Effectively contributing to building collaborative payor relationships that result in advantageous contract arrangements
• Understanding of medical cost trends that drive gains and losses across risk pools
• Ability to navigate within ambiguity, a service orientation, and a high level of humility are vital for successful assimilation into our highly collaborative, entrepreneurial culture
• Understanding of Medicare Advantage bid process
• Knowledge and understanding of health plan network operations preferred

Experience to drive change

• Demonstrated track record of building strong working relationships across operational leaders and potential payor partners
• Bachelor’s degree required; a focus in Business preferred
• 20+ years in progressive roles required
• Demonstrated analytical, project management, and leadership skills
• Experience with and understanding of health care reimbursement methods
• Experience modeling payor contracts
• Knowledge of value-based contract methodologies and preferred financial and administrative terms
• Experience negotiating quality and efficiency metrics preferred
• Ability to think independently, and develop new processes/analyses required
• Strong organizational skills with the ability to multi-task and execute against multiple competing priorities
• Proficiency in Excel, PowerPoint, and Word required
• Located in the NE with the ability to travel regionally 25-50% of the time

For Colorado Residents only: This is an exempt position. The base compensation range for this role is $235,000 - $350,000. 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 Commitment

Total 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/.