About UsVentra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.Come Join Our Team!As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewardsHelp Us Grow Our Dream Team — Join Us, Refer a Friend, and Earn a Referral Bonus!Job SummaryWe are seeking a Manager of Payer Strategy & Contracting to architect and execute our payer contracting strategy during a critical phase of organizational growth. This is a high-impact, externally facing role directly tied to revenue, margin, and scalability. The successful candidate will lead complex payer negotiations, design economically sound contract structures, and translate innovative care models into compelling payer value propositions. This role also serves as a strategic partner to senior leadership, ensuring payer agreements align with evolving care models, pricing strategy, and long-term margin goals.Essential Functions and TasksPayer Strategy & NegotiationLead end-to-end negotiation of payer agreements across fee-for-service (FFS), value-based, risk-bearing, and hybrid contract modelsOversee development of negotiation materials including rate benchmarking, reimbursement trend analysis, and financial impact modeling.Drive rate optimization and structure contracts that improve contribution margin and support long-term scalabilityLeverage established payer relationships to accelerate deal cycles and unlock favorable reimbursement termsReview and interpret health plan contract language across payor, medical group/IPA, and hospital/ancillary contextsApply working knowledge of the healthcare delivery system, IPA operations, managed care frameworks, and applicable healthcare law to develop contracting strategyEnsure payer contracts and fee schedules are accurately documented, maintained, and accessible.Build analytics tools and reporting that provide leadership with real-time visibility into payer performance and contract opportunitiesDeal Architecture & Financial AlignmentPartner with Legal, Finance, and Service Delivery to align contract terms with unit economics, pricing strategy, and regulatory requirementsPartner closely with Revenue Cycle, AR, and Billing teams to ensure contract terms are operationalized accurately within systems and workflows.Translate clinical programs — including virtual care, various modalities, and hospital-based professional settings into compelling, reimbursable contract modelsEnsure all agreements support enterprise goals around margin expansion and sustainable growthCross-Functional LeadershipServe as the central integrator across Legal, Finance, Clinical, and Service Delivery functions to structure and close dealsProvide clear, evidence-based guidance to internal stakeholders on contract tradeoffs, risks, financial impact, and strategic implicationsBuild internal clarity on how payer market dynamics affect product design, pricing, and operational executionSupport audit readiness and compliance with payer requirements, including documentation and contract interpretation guidanceMarket Intelligence & Relationship ManagementMaintain and deepen senior-level relationships with national and regional payersSurface actionable insights on payer priorities, reimbursement trends, and competitive positioningPosition the organization as a credible, preferred strategic partner across key payor accountsServe as a key point of contact for payor and physician client representatives, leading and participating in ongoing payer meetings, operational reviews, and strategic discussions with clients and payer partnersAnalytics & Performance MonitoringAnalyze payor performance, reimbursement trends, denial patterns, and payment variances to identify strategic opportunitiesDevelop payor and physician-client scorecards and KPIs to evaluate contract effectiveness and financial impactBuild and maintain financial models to support contracting, re-contracting, and new market entry decisionsSupport value-based contract management including quality metric tracking, shared savings calculations, and incentive reconciliationEducation and Experience RequirementsRequired8–10+ years of experience in managed care contracting, with a demonstrated track record leading negotiations with national and regional health plansProven ability to secure competitive reimbursement rates and structure complex agreements across FFS, value-based, and risk-based modelsEstablished strategic relationships with payor organizations at a senior levelDeep understanding of reimbursement methodologies: PFS, RBRVS, capitation, bundled payments, shared savingsDirect experience managing or supporting relationships with physician clients, medical groups, CINs, or IPAs on behalf of a provider organizationProficiency with financial modeling, contract performance analytics, and tools such as Excel, Tableau, or comparable platformsStrong organizational and time management skillsAbility to operate in a fast-paced, collaborative environmentHigh attention to detail in contract interpretation and executionStrong executive communication skills; ability to operate effectively at both leadership and operator levelsBachelor's degree in Healthcare Administration, Business, Finance, or a related fieldPreferredMBA or MHAExperience in virtual care, outpatient multi-site, or technology-enabled care delivery environmentsFamiliarity with Medicaid, Medicare Advantage, and pediatric reimbursement structuresExperience with contract management systems and knowledge of state and federal regulatory requirements (ACA, CHIP, network adequacy)Knowledge, Skills, and AbilitiesWhat Success Looks LikeAccelerated execution of high-priority payer contracts with improved rate structures and defined margin impactClear, documented linkage between payer agreements and pricing strategyEstablished scalable internal operating model for payer contractingStrengthened payor and physician-client relationships that position the organization for long-term partnership and network growthCompensationBase Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons.This position is also eligible for a discretionary incentive bonus in accordance with company policies.
