Senior Director, Strategic Payer Relations

Job not on LinkedIn

🔥 15 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

👔 Director

👻 Ghost score 10%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Open for 1 day.
• Jobs at this company usually fill in 24 days.
• No salary listed.

Apply Now

Check your resume score

Customize resume + cover letter

Find Similar Remote Jobs

☆ Save☑️ Mark as applied❌ Hide

Report problem

ExactCare

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2009

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

💰 Private Equity Round on 2016-03

Healthcare • Healthcare Insurance • Pharmaceuticals

ExactCare is a leading pharmacy care management provider that specializes in medication management for individuals with complex, chronic medical needs. With operations in all 50 states and Washington, D. C. , ExactCare supports more than 100,000 people nationwide, helping them manage their medications in assisted living, long-term care facilities, and at home. Partnering with healthcare organizations, ExactCare aims to improve clinical outcomes by ensuring better medication adherence, reducing readmissions, and lowering overall healthcare costs.

📋 Description

• Serve as primary relationship owner for a defined portfolio of strategic payer organizations • Lead executive-level engagement with payer stakeholders • Establish and maintain relationships supporting network access, retention, and reimbursement improvement • Ensure consistent communication and positioning across payer interactions • Lead master account planning and conduct payer quarterly business reviews • Independently manage payer relationships, developing strategies, priorities, engagement plans, and recommended actions • Drive initiatives to improve reimbursement performance and financial outcomes • Partner with contracting, clinical effectiveness, pharmacy, and finance teams on payer-specific strategies • Identify payer opportunities, risks, performance gaps, and emerging issues; determine root causes and mobilize stakeholders • Collaborate across Clinical Effectiveness & Stars Experience, Government & Professional Affairs, Strategic Contracting, and Market Strategy • Align payer engagement with enterprise priorities, regulatory considerations, and contracting strategies • Coordinate data, insights, and materials for payer discussions • Lead governance processes related to payer engagement, escalation, and decision-making • Prepare executive summaries, updates, and recommendations for senior leadership • Drive payer initiatives from strategy through execution with clear deliverables, owners, timelines, dependencies, and escalation points • Maintain accurate documentation of payer interactions, priorities, and outcomes • Develop scalable processes, tools, and best practices for the Strategic Payer Relations function • Support onboarding, mentoring, and collaboration with other Senior Directors • Assist the Vice President, Strategic Payer Relations, in shaping role clarity, engagement models, and operating cadence • Embody AnewHealth’s Core Values and perform other assigned duties

🎯 Requirements

• Bachelor’s degree required; advanced degree preferred • 10+ years of progressive experience in payer relations, health plan engagement, healthcare strategy, contracting support, or related healthcare leadership roles at payer organizations including PBMs, health plans, or government payer organizations • Demonstrated experience engaging senior-level payer stakeholders, including Directors, VPs, and SVPs • Strong understanding of payer structures, reimbursement models, network access dynamics, and healthcare economics • Proven ability to operate effectively in complex, matrixed organizations • Experience supporting payer strategies across national and/or regional payers preferred • Background working closely with contracting, clinical, pharmacy, or reimbursement-focused teams preferred • Experience contributing to new function or capability development within a healthcare organization preferred • Strong executive communication skills, written and verbal • Ability to synthesize complex financial, operational, clinical, and market information into strategic recommendations and executive-level narratives • Executive presence and credibility with external stakeholders • Strategic thinking and disciplined execution at a senior level • Strong collaboration and influence without direct authority • Analytical mindset focused on outcomes • Comfort operating in evolving and ambiguous environments • High degree of accountability and follow-through • Must be able to commute to multiple site locations within assigned territory • May be required to work extended hours as needed • Travel may be required for organization or department events, meetings, trade shows, conferences, and client engagements • Applicants must be eligible to work in this country

🏖️ Benefits

• Medical, dental, and vision coverage • Flexible spending • Company-paid life insurance • Company-paid short-term disability • Voluntary benefits • 401(k) • Paid Time Off • Paid holidays • Flexible remote work arrangement

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume