Partnership Development Manager - Payors / Health Plans

About the role

Ophelia Health is seeking a full-time Partnerships Manager to initiate and develop strong, lasting relationships with health plans (payors) to support members with opioid use disorder (OUD).

Responsibilities

• Build and manage relationships with key stakeholders across health plans, including: Case managers and care coordinators, Behavioral health teams, Population health and care management leadership.
• Serve as the day-to-day partner ensuring Ophelia is top-of-mind for appropriate member referrals.
• Design and implement referral pathways within health plan workflows to connect members to Ophelia.
• Partner with external care management teams to: Embed Ophelia into case manager workflows and escalation pathways, Ensure smooth referral processes (warm handoffs, clear eligibility criteria, simple intake).
• Drive adoption by making referrals easy, repeatable, and aligned with plan operations.
• Monitor referral trends and proactively engage case managers to increase appropriate referrals.
• Identify gaps in utilization and implement targeted strategies to improve performance.
• Education health plan teams on: Ophelia’s clinical model and outcomes, When and how to refer members, The value of MOUD in reducing total cost of care and improving outcomes.
• Position Ophelia as a trusted extension of the plan’s care management strategy.
• Track and analyze: Referral volume by plan and team, Conversion from referral → patient entering care, Engagement and retention metrics.
• Use data to: Identify high- and low-performing partners, Adjust outreach and engagement strategies.
• Report back to internal and external stakeholders on performance.

Requirements

• 2-5+ years of Health plan experience: Experience working with or within health plans (Medicaid managed care strongly preferred), with exposure to payor partnerships, care management/case management programs, or behavioral/population health.
• Utilization-focused operator: Proven ability to drive utilization and engagement within existing partnerships (not just close deals).
• Health plan fluency: Strong understanding of health plan operations, including case management workflows, member engagement challenges, and behavioral health care coordination.
• Stakeholder influence: Ability to engage and influence non-sales stakeholders (e.g., case managers, care coordinators, behavioral health teams) and build trust across clinical and operational teams.
• Data-driven execution: Highly analytical and comfortable using data to track performance, identify gaps, and adjust strategy to drive results.
• Operator mindset: Focused on execution, adoption, and measurable outcomes vs. just relationship-building.
• Cross-functional communicator: Able to translate between clinical care, payor priorities, and member needs to drive alignment and action.
• Mission-driven: Passionate about improving access to care for high-need, underserved populations.
• Ability to maintain professionalism and confidentiality when working with sensitive and confidential information.

Qualifications

• Preferred: Medicaid or dual-eligible populations, OUD/SUD treatment or behavioral health, Value-based care or cost-of-care reduction strategies, Experience with: Existing relationships within health plans or care management teams.

Skills

• Strong communication and interpersonal skills.
• Excellent organizational and project management skills.
• Ability to work independently and as part of a team.
• Proficiency in Microsoft Office Suite.

Benefits

• Competitive medical, vision, and health insurance (many plans are fully covered for the employee!)
• Start with 20 days (4 weeks) of PTO, increasing to 5 weeks after 2 years and 6 weeks after 5 years of tenure.
• 10 company holidays.
• Work From Home Stipend.
• 401k Contribution Platform.
• Additional benefits offered through our benefits provider such as life insurance, short and long term disability, financial wellness, virtual primary care, among others!

Pay

$80,000 - $100,000 USD

Schedule

Full-time