Director, Payer Contracting

Equality Health is an integrated, holistic, and tech-enabled healthcare delivery system focused on improving the health and wellness of diverse populations. Founded in 2015, Equality Health aims to improve access to value-based care for people who have long struggled with navigating the traditional one-size-fits-all U.S. healthcare system. The mission is to provide high-quality care that improves and enhances lives regardless of race, ethnicity, age, or income.

Through its supplemental care management services and proprietary technology platform, CareEmpower™, Equality Health helps managed care plans and health systems improve outcomes and lower costs for diverse populations while facilitating the transition to risk-based accountability. Equality Health supports over 800,000 members and more than 4,000 practice sites and continues to scale rapidly.

In 2021, Equality Health partnered with General Atlantic, a leading global growth equity firm, to drive continued expansion and fuel growth as a leading value-based primary care network serving the Medicaid, Medicare, and ACA Exchange populations. This investment enables further geographic expansion, technological innovation, and product development while increasing access to care, lowering costs, and improving outcomes for underserved individuals and communities.

About the Organization

Equality Health operates a dynamic value-based care platform that transforms healthcare by aligning, engaging, and empowering providers and health plans to focus on individuals and communities most in need. The core value proposition includes:

• Practice Transformation and Performance Support: Tools, high-touch practice and member support, and value-based incentives for primary care providers.
• Proprietary Technology: Actuarial intelligence and timely analytics supporting panel management, chart preparation, and connections to resources such as social determinants of health, behavioral health, and care management.
• Timely Value-Based Incentives: Quarterly payments to providers based on activity, supporting preventive care, transitions of care, and high-risk member management.
• Multidisciplinary Care Team: Digital member engagement, telephonic care navigation, field-based teams, community health workers, chaplains, and nurse practitioners.

Equality Health partners with managed care organizations (MCOs) to support state-led initiatives and holds participation agreements with providers to support their attributed Medicaid members. The company's footprint spans multiple states, including Arizona, Texas, Louisiana, Virginia, and Tennessee, with a growing network of affiliated primary care providers.

About the Role

Equality Health is seeking a dynamic and results-oriented Director, Payer Contracting Negotiator to execute and support the strategy, lead negotiations, and execute value-based agreements with Medicaid managed care organizations (MCOs). This role will play a critical part in expanding and optimizing payer partnerships that support high-quality, cost-effective care for underserved populations. The Director will operate at both strategic and tactical levels—structuring complex risk arrangements while ensuring contracts are operationalized effectively across markets. This role requires deep expertise in Medicaid reimbursement, value-based care models, and payer-provider dynamics.

Responsibilities

• Support and assist in designing innovative contract structures, including shared savings, downside risk, capitation, and bundled payment models.
• Align contracting strategy with enterprise growth goals, clinical models, and financial targets.
• Lead end-to-end negotiations with Medicaid managed care organizations and other payer partners.
• Manage executive-level relationships with payer counterparts.
• Position Equality Health as a preferred partner for value-based care delivery and population health management.
• Partner with finance, actuarial, clinical, and operations teams to ensure contracts are financially sound and operationally executable.
• Translate contract terms into clear performance expectations, KPIs, and reporting frameworks.
• Monitor contract performance, including medical cost trends, quality metrics, and risk adjustment outcomes.
• Lead renegotiations and optimizations based on performance insights.
• Collaborate with network development, provider relations, and clinical teams to align incentives and ensure provider readiness for risk-based models.
• Work closely with legal and compliance to structure contracts that meet regulatory requirements.
• Partner with finance and analytic teams to support pricing, forecasting, and performance measurement.
• Support entry into new markets by establishing payer relationships and securing contracts with Medicaid plans.
• Identify opportunities to expand the scope of existing contracts (e.g., new populations, services, or geographies).
• Provide regular updates to stakeholders on pipeline, contract status, and financial impact.
• Contribute to presentation materials related to payer strategy and performance.

Requirements

• Associate’s degree or higher and/or equivalent experience in a healthcare or related field of study.
• 10+ years of experience in payer contracting, network management, or healthcare business development.
• Deep expertise in Medicaid managed care and value-based payment models.
• Proven track record of negotiating and managing complex, risk-based contracts.
• Strong understanding of healthcare economics, including medical cost drivers, risk adjustment, and quality incentives.
• Experience working with or contracting on behalf of Medicaid managed care organizations, MSOs, ACOs, or risk-bearing provider groups.
• Experience in multi-state Medicaid environments and familiarity with state-specific regulations.
• Experience working cross-functionally to operationalize contracts in provider or payer organizations.
• Excellent negotiation, communication, and relationship management skills.

Preferred Qualifications

• Strong, trusted relationships with key Medicaid health plans.
• Background in top-tier consulting firms such as McKinsey & Company, Bain & Company, or Boston Consulting Group, with a healthcare focus.
• Strong analytical and financial modeling capabilities.
• MBA, MHA, or related advanced degree.