Sr. Director of Payor Relations
Sr. Director of Payor Relations
Friday, October 31, 2025
Direct Hire
El Segundo, California, United States
The Senior Director of Payor Relations will lead and grow strategic partnerships with payors, including but not limited to MCOs, the VA, and other funding sources, to proactively shape a favorable environment for the organization's expansion and impact. This is a highly commercial, field-based, customer-facing role that requires strong influence, negotiation, and communication skills. The role is accountable for expanding market access, improving reimbursement terms, and positioning the organization as a high-value, trusted partner across California. By enabling deeper alignment with payors and delivering on shared priorities, you will support the organization's growth and ensure more individuals and communities have access to high-quality, life-enhancing services.
You will work across teams to streamline operations, align services with payor needs, and ensure compliance with key program requirements including but not limited to Medi-Cal, CalAIM, and VA.
Your leadership will directly enable growth by expanding payor reach and securing favorable policies, contract terms, and rates that support sustainable, quality-driven expansion. By aligning payor partnerships with organizational strategy, you will help ensure the company's long-term impact, financial strength, and ability to serve more communities statewide.
Strategic Partnerships & Influence:
- Lead and strengthen strategic, field-based relationships with payors—including MCOs, the VA, and other funding entities—to position the organization as a proactive, high-value partner committed to improving and expanding access to care.
- Influence payor strategy, policy, and program design to create favorable conditions for scalable and sustainable growth, working closely with Government Relations to ensure the organization is positioned as a proactive thought partner—not just a provider.
- Represent the organization in external forums, workgroups, governance bodies, and board-level discussions (e.g., Medi-Cal, CalAIM, VA) by pre-reviewing key materials, synthesizing insights, and effectively influencing outcomes with a working knowledge of governance and related processes.
- Serve as the primary point of escalation for payor relationship or contract issues, ensuring concerns are addressed and resolved in a timely, strategic manner.
- Identify and mitigate risks in payor relationships, contracts, and policy changes, proactively protecting the organization's financial and strategic position.
Contracting & Negotiations:
- Negotiate contracts and terms with payors—including MCOs, the VA, and other funding partners—that align with organizational strategy, growth priorities, and sustainability goals.
- Secure reimbursement and partnership structures that support financial sustainability, quality outcomes, and service expansion.
- Partner with finance, compliance, government relations, operations, and community development teams to ensure contracts are financially and operationally viable as well as fully compliant with Medi-Cal, CalAIM, VA, and other ongoing regulatory and policy requirements.
Growth Enablement:
- Drive growth by expanding payor reach and strengthening the organization's position as a preferred, trusted partner across diverse payor types—including MCOs, the VA, and other funding partners.
- Drive lead generation through key account management with payors, including regular value-driven touchpoints, education, and proactive communication that encourage referrals and utilization of contracted services.
- Create new opportunities for the Community Development team by building relationships and opening doors with payors for program expansion.
- Identify, elevate, and execute on aligned opportunities for partnership, service line, geographic, and funding model expansion in collaboration with Community Supports leadership and TEAM Strategy.
- Leverage data and analytics to monitor payor performance and utilization trends, providing insights to strengthen relationships and support growth initiatives.
- Proactively analyze payor data to identify trends, uncover opportunities, and make actionable recommendations to leadership for strategy, partnership, and growth decisions.
- Act as a cross-functional liaison, translating payor requirements, priorities, and feedback into actionable initiatives to support alignment, compliance, and growth.
Position Details:
- This California-based role is perfect for someone located near a major airport, as it requires up to 80% in-state travel.
- You'll spend much of your time out in the field meeting with payor partners, agencies, and community teams, playing a key role in shaping the future of care across California.
- It's a hybrid position with minimal office requirements, reporting into our El Segundo, CA office just once per quarter.
- We're proud to offer a competitive package that includes a base salary of $160K–$200K, plus bonus and commission opportunities, a car stipend, and comprehensive benefits designed to support your success and well-being.
WHAT YOU BRING TO THE TABLE:
Qualifications and Education Requirements:
- Bachelor's degree in business, Healthcare Administration, Public Policy, Finance, or related field; Master's preferred.
- 7+ years of experience in payor relations, managed care contracting, Medicaid/Medicare strategy, or government healthcare programs.
- Deep knowledge of California Medi-Cal and CalAIM programs required, VA program experience strongly preferred.
- Proven track record in contract negotiation, payor relationship management, and influencing payor policy or program design.
- Experience collaborating with cross-functional teams (finance, operations, compliance, community development, etc.).
- Demonstrated ability to analyze data and provide strategic recommendations for growth and risk management.
- Experience managing multiple payors or large-scale managed care programs.
- Proficiency with CRM and project management platforms, including Salesforce and tools such as Monday.com, Asana, or Trello.
Skills:
- Relationship Management & Influence: Ability to build trust and credibility with payors—including MCOs and the VA—regulators, and internal stakeholders.
- Negotiation & Contracting: Skilled in structuring agreements, securing favorable terms, and influencing payor policies.
- Analytical & Strategic Thinking: Able to interpret payor data, uncover insights, and make actionable recommendations to leadership.
- Cross-Functional Leadership: Effectively collaborates with finance, operations, compliance, government relations, strategy, and community development teams.
- Communication & Presentation: Strong verbal and written communication; able to represent the organization in external forums, workgroups, and executive-level discussions.
- Project Management: Ability to manage multiple payor relationships, contracts, and initiatives simultaneously.
- Risk Awareness: Proactively identifies and mitigates financial, operational, and regulatory risks.
- Problem Solving & Decision-Making: Able to respond quickly to emerging payor issues and guide escalation when needed.