Director, Payor Strategy and Contracting

About us

SimpleHealth is on a mission to reduce unnecessary doctor visits and save patients time and money. Come be part of a bright and passionate team that loves to solve hard problems and seeks to drive down spiraling healthcare costs.

We have a diverse culture rooted in honesty and transparency, and we know that each voice matters.

We strive to ensure that everyone has a healthy work-life balance, with a minimum vacation policy, work-from-home, flexible scheduling, and paid parental leave. Teammates are encouraged to continue learning, both in their specialty and within their other interests. Growth is not confined to job descriptions, with active encouragement to try other roles within the organization. 

The Role

We are seeking an energetic, creative, and experienced dealmaker to lead our strategic payor and employer relationships. As the Director, you will be responsible for the strategic direction of SimpleHealth’s relationships with customer segments including commercial and medicaid health insurers, PBMs, and pharmacies and closing deals with these customers. You will lead the coordination of payor engagement efforts and the development and implementation of strategies and plans to drive sustainable and profitable arrangements with these customers. You’ll develop a process to monitor the health of these customer relationships and translate findings into actionable initiatives, narratives, and campaigns to win and maintain trust in this customer segment. 

In this role, you will be responsible for both driving the strategy and execution for how SimpleHealth should engage and build innovative relationships with a broad range of players in the payor space, ranging from PBMs to insurers and self-insured employers, to HSA providers, as well as leading outreach and negotiation of contracting. You will use your extensive payor network to connect and work with partners to understand how SimpleHealth can both integrate with and revolutionize traditional payor business models. You will work closely with the CEO to build outside-the-box ideas for how payor relationships can enable broader reach and sustainable economics for their businesses. As the leader of our payor organization, you will be responsible for building a team that can source, close, and manage partnerships across the payor landscape, expanding access to a seamless and delightful healthcare experience for millions of patients.

The ideal candidate has experience within a leading payor, PBM, pharmacy or healthcare company. You are an expert networker and seasoned negotiator who is able to context-switch with ease and demonstrates a mastery of both the strategy and sales aspects of payor relations. 

Essential Functions

• Establish and maintain impactful external relationships with executives and key decision makers, within health plans and PBMs
• Source, negotiate, and close contracts to expand patient lives covered and increase reimbursement rates
• Build out and develop the commercial relationship team to create commercial relationships with employers and payors
• Develop and execute SimpleHealth’s strategy to broaden and deepen payor and PBM relationships
• Demonstrate in depth knowledge of medical consumers to negotiate innovative value-based propositions and strategic pricing agreements
• Develop and lead payor value propositions that communicate clinical, economic, and overall value of SimpleHealth
• Integrate and coordinate with other functions (marketing, product, engineering, legal, finance) to ensure all market access needs are met across the organization
• Help develop and create assets and tools to communicate with and engage payors and PBMs
• Keep abreast of industry developments and economic and payor policy through conferences and/or medical literature and represent these as a subject matter expert to the executive leadership team and cross functional stakeholders
• Support pre-contract analysis activities and identify appropriate contracting opportunities to include business case
• Perform contract reviews with team members as needed to monitor progress of KPI measures

Your Qualifications

• 8+ years of high-performance payor execution experience, working with or at a national payor, regional Blue, PBM, pharmaceutical or healthcare company
• Extensive experience with negotiating and contracting in the payor space
• Deep knowledge of payor economics and business models, and how innovations such as telemedicine, disease management, and remote monitoring will impact the future of reimbursement
• Excellent written and verbal communication skills and the ability to tailor them to individual personalities
• Strong project management skills with the ability to manage multiple projects and the desire to bring structure to undefined procedures
• Strong analytical and quantitative skills, an ability to wrangle, digest, and glean actionable insights from data, yet unafraid to use your judgement and trust your instincts
• Ability to champion, lead, and mentor a team 
• Passion for reproductive health and the mission of expanding access to healthcare
• Must have knowledge of the healthcare industry, including strong relationships with and/or ability to connect to healthcare executives
• Track record of success in closing deals 
• Technical knowledge of healthcare reimbursement from a patient and provider perspective
• Knowledge of current and future healthcare policies and trends
• Strong contracting and negotiations skills

Work Requirements

• Remote
• Typing and computer usage throughout the day
• Standard business hours M-F
• Travel requirements: < 25%
• No lift requirements

We Offer!

• Competitive Compensation 
• Company Equity 
• Paid Health Benefits for Employees
• Paid Vacation/Sick Time
• Paid Holidays
• Paid Medical Leave
• Paid Parental Leave
• Flexible Schedules

We think you should join us. Here’s why:

• We see things differently. That’s why we’re building a diverse culture - with people who bring unique perspectives & backgrounds to the table. We need a diverse team to build products that serve our diverse patients.
• We’re humans first, employees second. Work-life balance matters to us - that’s why we require minimum vacation time, are flexible with when and where you work, offer paid parental leave & more.
• We’re building for longevity. Growth is not confined to job descriptions or teams, and we encourage continuous learning, both within your specialty and in other interests.
• Health matters to us, including yours. We offer benefit plans that pay 100% of employee healthcare and dental premiums, and a membership with One Medical.

Disclaimers

The Company provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

 This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time with or without notice.