Location: New York City, NY (Hybrid)
Carex is partnering with a healthtech startup partner to identify a strategic, results-driven Head of Payor Partnerships to lead health plan relationships, drive payor contracting strategies, and expand value-based care partnerships nationwide. This is a high-impact leadership opportunity to shape go-to-market and reimbursement strategies. Reporting directly to the CEO, this individual will oversee the full lifecycle of payor partnerships, from market identification and business development through contract negotiation, implementation, and performance management. The ideal candidate brings deep healthcare industry knowledge, proven value-based care contracting experience, and the ability to build strong relationships with commercial and government payors. Success in this role requires a combination of strategic thinking, financial acumen, and hands-on execution in a fast-paced, entrepreneurial environment.
What You’ll Do
-
Lead the identification, development, negotiation, and implementation of strategic partnerships with commercial and government payors to support market expansion and value-based care initiatives.
-
Develop and execute a comprehensive payor engagement strategy, including market prioritization, prospecting, outreach, referrals, industry events, and relationship development.
-
Establish and maintain strong relationships with health plan executives, network leaders, and key decision-makers to identify opportunities for mutually beneficial partnerships.
-
Own the end-to-end payor contracting lifecycle, including opportunity assessment, financial analysis, term sheet development, contract negotiation, legal review, implementation, and go-live.
-
Drive value-based care contracting initiatives, aligning reimbursement methodologies, financial incentives, and performance expectations with organizational capabilities and partner objectives.
-
Develop market-specific financial and operational models evaluating revenue opportunities, utilization trends, provider types, product lines, reimbursement structures, and contract economics.
-
Create and execute negotiation strategies supported by financial modeling, market intelligence, and a thorough understanding of payor priorities.
-
Lead contract review and redlining efforts, collaborating with legal, finance, operations, and other stakeholders to ensure favorable and sustainable agreements.
-
Partner cross-functionally to support successful implementation, operational readiness, and ongoing management of payor agreements.
-
Monitor partnership performance, identify opportunities for optimization, and communicate actionable insights to internal leadership and external stakeholders.
-
Establish and track key performance indicators (KPIs) to measure contracting progress, partnership effectiveness, financial performance, and strategic impact.
-
Maintain accurate pipeline reporting, market intelligence, and deal activity using CRM platforms such as Salesforce or HubSpot.
-
Represent the organization at industry conferences, networking events, and strategic partner meetings to strengthen market presence and develop new business opportunities.
What You’ll Bring
-
4–6 years of experience in healthcare, preferably in payor relations, business development, health plan partnerships, provider network management, or a related external-facing role.
-
Demonstrated experience with value-based care contracting, either through direct ownership or significant involvement in contract development, negotiation, or execution.
-
Strong understanding of commercial and government payor environments, healthcare reimbursement models, and the evolving value-based care landscape.
-
Proven ability to develop and execute strategic partnership initiatives, manage complex negotiations, and build relationships with senior-level healthcare executives.
-
Experience preparing proposals, developing negotiation strategies, and presenting complex financial or partnership recommendations to C-suite stakeholders.
-
Strong analytical and financial acumen, with proficiency in financial modeling, contract performance analysis, market assessment, and data-driven decision-making preferred.
-
Experience reviewing, negotiating, and managing healthcare contracts, including familiarity with reimbursement methodologies, contract terms, and implementation requirements.
-
Excellent project management and organizational skills, with the ability to coordinate cross-functional initiatives and manage multiple priorities simultaneously.
-
Strong communication, presentation, and relationship-building skills, with the ability to influence stakeholders and translate complex concepts into actionable strategies.
-
Familiarity with CRM platforms such as Salesforce or HubSpot for pipeline management, relationship tracking, and performance reporting.
-
Highly detail-oriented, proactive, and comfortable operating independently in a dynamic, high-growth environment.
-
Entrepreneurial mindset with a strong sense of ownership, sound judgment, and a demonstrated ability to move initiatives from strategy through execution.
-
Willingness to travel approximately monthly for industry conferences, partner meetings, and business development activities.
Total compensation is $200k-$220k plus equity.
Carex Consulting Group is an equal opportunity employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, marital status, disability, gender identity or Veteran status.
#LI-SM1