Senior Director, Payer Contract Administration

What You'll Do:

The Senior Director, Payer Contract Administration, reporting directly to the Chief Growth & Development Officer, manages, negotiates, and optimizes payer agreements, to support the execution of the Company’s payer contracting process strategy. This role sits at the intersection of revenue cycle management, payer relations, and organizational growth, requiring both deep technical knowledge of managed care contracting and the ability to build collaborative, trust-based relationships with health plans, and government payors.

This role will be responsible for the payer contracting lifecycle process, including pre-negotiation preparation and market analysis, contract execution, ongoing administration, and performance monitoring. The individual in this role is expected to serve as a subject matter expert on Medicaid, commercial health plan structures, and government payor frameworks, applying that expertise to maximize Connections' reimbursement rates, protect contractual rights, and ensure alignment with clinical delivery models.

The Senior Director requires close collaboration with internal partners across business development, clinical operations, revenue cycle management, legal, and finance to ensure that every payer relationship is managed with precision and integrity. The Sr. Director will also actively support corporate development initiatives, RFP responses, and new market expansion efforts, contributing substantive contracting expertise to each engagement.

Payer Communication

The Sr. Director plays a central role in communicating Connections' unique value proposition to payer partners and external stakeholders. This includes:

• Clearly articulate Connections' clinical model, outcomes data, population expertise, and care delivery approach to health plan partners, government agencies, and other contracting entities.
• Translating complex clinical and operational capabilities into contractually relevant value statements that support favorable rate and term negotiations.
• Negotiating agreements that reflect a thorough understanding of market dynamics, reimbursement trends, and Medicaid-specific frameworks including rate structures and service definitions.
• Aligning contracting approaches for new markets and adjacent service lines with the organization's demonstrated capabilities and value-based care commitments.
• Developing and maintaining materials that support payer presentations, including rate justification documents, outcome summaries, and service capability profiles.

Cross-Functional Collaboration

The Sr. Director operates as a highly collaborative leader across multiple internal functions, providing contracting expertise that enables the broader organization to execute effectively:

• Partnering with the business development team to ensure that go-to-market activities are supported by appropriate contractual frameworks, from initial opportunity identification through contract execution.
• Supporting RFP responses and proposal development by contributing substantive knowledge of reimbursement structures, contract terms, and payor requirements.
• Collaborating with corporate development on acquisitions, partnerships, and new revenue initiatives to assess contracting feasibility and ensure proper payor coverage is established.
• Working with clinical and operations leadership to ensure that all executed contract terms support the fidelity of Connections' care delivery model and can be operationalized effectively at the program level.
• Liaising with finance and revenue cycle teams to provide accurate projections of contracted revenue and identify opportunities to improve reimbursement performance.
• Communicating proactively with leadership regarding payer issues, rate changes, regulatory updates, and contracting risks that may affect organizational revenue or operations.

Contract Management & Performance Monitoring

Beyond initial execution, the Sr. Director manages the post execution contract administration process ensuring that payer relationships and contracts continue to perform effectively:

• Establishing and monitoring key performance indicators (KPIs) for each payer relationship, including reimbursement accuracy, claim approval rates, and payment cycle compliance.
• Conducting periodic contract performance reviews to identify gaps, underperforming rate categories, or terms that warrant renegotiation.
• Proactively managing payor relationships to foster ongoing goodwill, resolve operational issues, and position Connections favorably for future contract renewals or expansions.
• Staying current with regulatory changes, Medicaid policy updates, and managed care market trends that may affect reimbursement or contract structures in active and prospective markets.

Performing all other duties as assigned by the Chief Growth & Development Officer.

This is a remote position with approximately 25% travel, primarily to engage with external payor entities, attend industry conferences, and collaborate with internal teams across Connections markets.

This is a fully remote position in these states: AL, AR, AZ, CA, CO, CT, DC, FL, GA, IA, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MT, NC, NJ, OH, OR, PA, RI, SC, TN, TX, UT, VA, WA

What You'll Bring:

• Bachelor's degree.
• 8 – 12 years in managed care and or high functioning provider organization, with extensive experience in contracting, business development and new and existing market expansion.
• Experience negotiating and executing payor contracts.
• Deep knowledge of Medicaid, government payor systems, and the complexities of contracting with risk-bearing entities.
• Demonstrated success in negotiating high-impact contracts that support both organizational growth and clinical quality.
• Experience in cross collaboration in a team structural,
• Strong project and people management skills.
• The Company has a mandatory vaccination policy. All successful applicants must be fully vaccinated, including showing proper documentation, or otherwise be exempt pursuant to the Company’s exemption process prior to their start date as a condition of employment.

It would be great if you had:

• MBA or MHA from a leading program/institution
• 8+ years of managerial experience reporting to a senior level executive
• Experience contacting with or on behalf of health plans for behavioral health related services

What We Offer:

Full-time only:

• Employees (and their families) are offered comprehensive health insurance, including Medical, Dental, Vision, Accident, Critical Illness, and Hospital Indemnity
• CHS pays for Basic Life, AD&D, Short and Long-Term Disability
• Voluntary Life insurance option for employees and their families
• Health Savings Accounts (with $1,000 to $2,000 employer contribution depending on plan)
• Flexible Spending Accounts (health care and dependent care)
• 401k company match after 6 months (50% of deferrals up to 6% of compensation)
• Generous PTO starting at 160 hours accrued annually and 12 recognized company holidays
• Company‑paid parental leave available to eligible employees

All employees (Pool, Part-time and Full-time):

• Employee Assistance Program to help with confidential emotional support, work life solutions, financial solutions, legal assistance, or online support
• After 90 days, you are auto enrolled in the 401k Plan

EEO Statement

Connections Health Solutions is an equal opportunity employer. We do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law. We are committed to creating an inclusive and welcoming environment for all employees and applicants.