About this role
When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.
Reporting to the Vice President, Payer Strategy, the Executive Director, Payer Contracting serves as a senior leader responsible for the development, negotiation, implementation, and ongoing management of payer contracts and reimbursement strategies across Beth Israel Lahey Health Performance Network (BILHPN) and affiliated Beth Israel Lahey Health (BILH) entities.
The Executive Director leads complex payer negotiations across commercial, Medicare, Medicaid, Medicare Advantage, Dual Eligible, and value-based payment arrangements while supporting the execution of the enterprise payer strategy established by the Vice President. This role is responsible for managing strategic payer relationships, overseeing contracting operations, supervising contracting staff, and partnering across finance, analytics, legal, operations, and clinical leadership to achieve system financial, quality, and growth objectives.
The Executive Director plays a critical role in advancing innovative contracting and payment models that support BILH's transition toward value-based care while ensuring competitive reimbursement, operational alignment, and long-term sustainability.
Job Description:
Primary Responsibilities
Payer Contracting Strategy and Negotiations
- Leads the negotiation, implementation, and management of payer agreements across commercial, Medicare, Medicaid, Medicare Advantage, Dual Eligible, and other government-sponsored programs, consistent with enterprise payer strategy. (Essential)
- Serves as lead negotiator for assigned payer relationships and supports enterprise negotiations led by the Vice President, Payer Strategy. (Essential)
- Develops negotiation strategies, reimbursement proposals, financial modeling assumptions, and contract scenarios designed to improve organizational performance and market position. (Essential)
- Collaborates closely with the Vice President to translate enterprise strategic priorities into contract structures, reimbursement terms, and operational requirements. (Essential)
- Evaluates proposed payer contract terms and identifies financial, operational, and strategic implications for BILHPN and affiliated BILH entities. (Essential)
Value-Based Contracting and Payment Innovation
1. Develops, negotiates, and implements alternative payment arrangements, including:
- Shared savings models
- Shared risk arrangements
- Population-based payment models
- Quality incentive programs
- Bundled payment methodologies
- Value-based reimbursement structures
2. Works closely with Medical Economics, Contract Analytics, Finance, Population Health, and Clinical Leadership teams to ensure reimbursement methodologies appropriately reward quality, affordability, access, and accountability.
3. Monitors industry trends, regulatory developments, and emerging reimbursement models to inform contracting strategies and identify new opportunities for innovation.
Stakeholder Engagement and Relationship Management
1. Develops and maintains productive relationships with payer executives and contracting leaders to facilitate collaboration, resolve issues, and advance strategic priorities.
2. Partners with physician, hospital, operational, and executive leaders across the BILHPN network to build consensus around contracting priorities and implementation strategies.
3. Influences key internal stakeholders and facilitates alignment across diverse constituencies whose business objectives may be impacted by payer contract negotiations.
4. Represents BILHPN and BILH in external payer discussions, industry forums, and collaborative initiatives as appropriate.
Contract Performance and Governance
1. Oversees the implementation and operationalization of payer contracts to ensure financial, operational, quality, and service-level objectives are achieved.
2. Works with Contract Analytics and Medical Economics teams to monitor contract performance, identify opportunities for improvement, and recommend corrective action as needed.
3. Oversees contract governance processes, including contract review, approval, execution, performance monitoring, contract renewal planning, and contract repository management.
4. Partners with Legal, Compliance, Finance, and Operations leaders to ensure contracts are operationally feasible, financially sound, and compliant with applicable requirements.
5. Supports preparation of materials and presentations for BILHPN Leadership, Finance and Contract Committees, Executive Leadership Teams, and Boards.
Leadership and Team Development
1. Provides leadership, direction, coaching, and professional development for the payer contracting team.
2. Establishes departmental goals, priorities, performance expectations, and succession planning initiatives.
3. Fosters a culture of collaboration, accountability, innovation, continuous improvement, and service excellence.
4. Responsible for hiring, performance management, employee engagement, corrective action, and workforce planning activities.
Leadership Responsibilities
- Direct Reports: Contracting Managers, Senior Contracting Professionals, and Contracting Analysts.
- Leads a team responsible for payer negotiations, contract administration, and contract implementation.
- Works collaboratively with Medical Economics, Contract Analytics, Population Health, Finance, Legal, and Operations teams.
- Serves as a key member of the BILHPN leadership team.
Required Qualifications
Education
- Bachelor's degree required.
- Master's Degree in Business Administration, Healthcare Administration, Public Health, Finance, or related field strongly preferred.
Experience
- Minimum of 10 years of progressive experience in managed care contracting, payer strategy, healthcare finance, or provider reimbursement.
- Minimum of 5 years of payer contract negotiation experience with direct accountability for financial performance and contracting outcomes.
- Minimum of 5 years of leadership experience managing professional staff and complex cross-functional initiatives.
- Experience negotiating contracts across: Commercial health plans
- Medicare Advantage
- Medicaid Managed Care
- Dual Eligible programs
- Value-based and risk-based reimbursement arrangements
Preferred Experience
- Experience within an integrated delivery system, clinically integrated network, health system, payer, or accountable care organization.
- Experience supporting enterprise-wide payer strategies and large-scale contract transitions.
- Experience leading implementation of innovative value-based care models and payment reform initiatives.
- Experience presenting complex financial and contracting issues to executive leadership and governing boards.
Core Competencies
- Strategic Thinking: Ability to translate enterprise payer strategy into executable contracting initiatives that support system growth, financial performance, and value-based care objectives.
- Negotiation and Influence: Demonstrated success leading complex negotiations and influencing outcomes with payers, executives, physicians, and external stakeholders.
- Business Acumen: Deep understanding of healthcare reimbursement methodologies, payer economics, provider finance, population health, and value-based care.
- Relationship Management: Ability to establish credibility and build trusted partnerships with payer executives and senior leaders across BILH and BILHPN.
- Financial and Analytical Expertise: Ability to assess contract performance, reimbursement methodologies, risk arrangements, and financial implications of negotiated agreements.
- Leadership: Ability to attract, develop, motivate, and retain high-performing teams while driving accountability and results.
- Communication: Exceptional written, verbal, and presentation skills with demonstrated ability to communicate complex concepts to executive, clinical, operational, and board-level audiences.
Social/Environmental Requirements:
1. Work requires close attention to task for work to be accurately completed. Intermittent breaks during the work day do not compromise the work.
2. Work is varied every day and the employee needs to be adaptable to respond to these changes and use independent judgment and manage priorities.
3. No substantial exposure to adverse environmental conditions
4. Health Care Status: NHCW: No patient contact.- Health Care Worker Status may vary by department
Sensory Requirements:
Close work (paperwork, visual examination), Color vision/perception, Visual monotony, Visual clarity > 20 feet, Visual clarity feet, Conversation, Telephone.
Physical Requirements:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally
This job requires frequent Keyboard use. There may be occasional standing.
Pay Range:
$187,200.00 USD - $228,800.00 USD
The pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.