Director, Health Plan Contracting

Overview

At Groups, we change lives. Our care model ties our beliefs about the power of community and counseling with evidence-based medicine and supporting the holistic needs of those we serve. Today, as the largest value-based outpatient addiction treatment provider in the U.S., we bring care directly to those who need it, especially in communities that traditional providers overlook. We're proving that value-based care can thrive in the Medicaid population while achieving exceptional results at scale. Unlike traditional providers who are paid for the volume of services, we are paid for results - enabling us to expand treatment access while delivering remission and retention rates far above the national average.

Responsibilities

Groups is seeking a Director of Health Plan Contracting to support its expansion into new markets. Reporting to the Senior Vice President, Payer Partnerships, this role is responsible for:

• Health Plan Partnership Development: Identify, outreach, and engage prospective health plan partners in key states
• Value Proposition: Clearly articulate Groups' unique value proposition to prospective health plans and tailor messaging to various audiences
• Deal Execution: Navigate matrixed organizations in service of negotiating value-based contracts that benefit Groups' plan partners, members, and organization
• Market Strategy: Integrate information on the regulatory environment, market dynamics, and organizational priorities in each state to create tailored partnership arrangements that expand member care.

Responsibilities

• Stay informed about national and state regulations and legislation affecting health plan operations in each market, and identify new states for potential expansion.
• Research and identify champions for value-based SUD care within health plans to begin contracting conversations
• Clearly articulate Groups' clinical model, outcomes, and value proposition to senior health plan executives, and lead discussions on Substance Use Disorder (SUD) needs.
• Partner with health plans to analyze data and pinpoint areas where Groups can provide added value.
• Manage the complete contracting process, from initial contact and presentation to negotiation and finalization, adapting to specific payer requirements.
• Collaborate with Partner Success to ensure health plans recognize and can articulate the value of Groups' care within their organizations.

Qualifications

• 5-8 years of experience in the healthcare sector, ideally with 2-4 years of experience partnering with or working at health plans.
• Outstanding interpersonal, communication, relationship-building, organizational, and time-management skills.
• Comfortable leading executive discussions and customizing content to individual stakeholders.
• Strong ability to influence decision-makers and translate discussions into commercial opportunities.
• Establishes credibility and rapport with both health plan and internal stakeholders.
• Strong healthcare acumen and knowledge of Medicaid and the health plan landscape.
• Willingness and ability to travel approximately 20%.