Head of Payor Strategy

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Abby Care

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

👥 B2C

Healthcare Insurance • B2C

Abby Care is a service that helps families get paid for providing in-home care to loved ones with disabilities or special needs. The organization trains and certifies family caregivers at no cost, manages hiring and payroll, navigates Medicaid and insurance paperwork to secure payment, and provides a purpose-built platform, clinical support, and community resources. Abby Care operates in multiple U. S. states and focuses on enabling high-quality, compensated family caregiving through partnerships with insurers and Medicaid programs.

📋 Description

• Own relationships with Medicaid MCOs, Medicare Advantage plans, and commercial health plan partners across current and target markets • Lead contract negotiations for new market entries, rate increases, and value-based program structures • Define and execute the company's payor roadmap: which plans to prioritize, on what terms, in what market sequence • Build the payor infrastructure from the ground up: reporting cadences, performance dashboards, quality tracking, and plan-facing analytics • Partner with clinical leadership to design and articulate an outcomes story that resonates with what health plans actually care about • Work with finance to model contract economics, pressure-test rate assumptions, and protect margin at scale • Represent Abby Care at health plan meetings, state conferences, and industry forums

🎯 Requirements

• Experience setting an organization’s health plan strategy — from the plan side (network strategy, provider contracting, government programs, or consulting) or the operator side (Director/VP Payor Strategy, Head of Commercial, CRO, or equivalent at a digital health company) • Track record of negotiating and closing contracts with Medicaid MCOs, Medicare Advantage plans, or commercial insurers. • Fluency in how plans buy, contract, and measure performance: PMPM and FFS rate structures, authorization mechanics, value-based care arrangements, quality frameworks (HEDIS, CAHPS, state-specific KPIs) • Understanding of the regulatory and contracting environment for home-based care services or a demonstrated ability to develop deep domain expertise quickly • Ability to work across internal teams (clinical, finance, product, legal) and serve as the connective tissue between what we deliver and what plans will pay for • We are not tied to a specific title or years of experience. What matters is that you have negotiated and closed consequential deals with health plans and can show the results.

🏖️ Benefits

• Competitive compensation packages that reflect the value you bring. We reward our team for the impact of their work – full-time employees are eligible for an annual company performance bonus. • Comprehensive health coverage that works for you. Choose from high-quality medical dental and vision options, including a $0 deductible PPO and a company-funded HSA, alongside employer-paid life and disability insurance. • Generous paid time off. We provide policies that allow you to recharge along with 10 paid company holidays. • Financial savings benefits to support your future. We support your financial well-being with HSA contributions, optional FSA and commuter benefits, and full coverage of all 401(k) account fees (employer match not currently offered). • Paid parental leave to support your growing family. We provide paid leave, so you can focus on bonding and adjusting to life as your family grows.