Director Payor Partnerships and Network Operations

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.

Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.

The Director, Payor Partnerships and Network Operations will be a key leader within the organization partnering with internal and external teams to facilitate competitive pricing, YOY revenue growth and alignment with Enterprise revenue growth strategy.   

This role will be responsible for the financial analysis of all FFS and VBC contracts with national payors across various lines of business, including Commercial (employer and individual exchange), Medicare Advantage and Managed Medicaid. The divisional scope of responsibility for this role will include Village MD, SMG, CityMD and Starling divisions.

In collaboration with VillageMD, SMG, CityMD and Starling Business leaders, respective Finance organizations, and Payor contractors, the Director will help establish performance targets both locally and at Enterprise level, annual budgets, and financial improvement strategies.

Key Responsibilities:

• Lead and manage a team inclusive of both internal and external resources, direct and matrixed resources, focused on driving revenue, margin, growth, and performance through detailed analysis of payor contracts.
• Develop and implement models to analyze reimbursement rates and identify opportunities for improvement.
• Advise senior leadership on financial strategies to optimize contract performance and profitability.
• Leverage data analytics, business insights, and cross-functional collaboration to drive operational and financial optimization.
• Analyze and interpret claim-level data, as well as broader trended metrics, to assess and communicate performance impacts to internal and external stakeholders.
• Build strong relationships with senior operations leadership to develop solutions for complex business issues.
• Support the development of monitoring FFS and VBC contract performance across multiple payers and lines of business.
• Implement strategies to ensure competitive …