abby-care - Head of Payor Strategy
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.
Responsibilities
• 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
Benefits
• C-level partnership. Direct access to and collaboration with our CEO and executive team on market strategy, pricing, and expansion decisions. • Own the function. You define the strategy, build the relationships, structure the deals, and own the outcomes. • Full-spectrum payor portfolio. Medicaid MCOs, Medicare Advantage, and commercial health plans; you will build a program that spans the full continuum of how home-based care gets financed in America today. • Clinical partnership. Work alongside our Head of Clinical to design outcomes-based programs that differentiate us in plan conversations and justify superior rates. • 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.
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