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Medsuite Inc

Manager, Payer Strategy – Contracting

Medsuite Inc

Manager of Payer Strategy executing payer contracting strategy during organizational growth at Ventra Health. Leading complex payer negotiations and translating care models into payer value propositions.

Posted 5/28/2026full-timeRemote • 🇺🇸 United StatesSeniorLeadWebsite

Tech Stack

Tools & technologies
Tableau

About the role

Key responsibilities & impact
  • 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

What you’ll need
  • 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

Benefits

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

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
managed care contractingpayer negotiationscontract structuresfinancial modelingreimbursement analysisrate optimizationcontract performance analyticsreimbursement methodologiesKPI developmentcontract interpretation
Soft Skills
organizational skillstime managementcollaborationattention to detailexecutive communicationstrategic partnershipleadershipanalytical thinkingproblem-solvingrelationship management
Certifications
Bachelor's degree in Healthcare AdministrationBachelor's degree in BusinessBachelor's degree in Finance