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Remote Payer Strategy Jobs in Washington (NOW HIRING)

Humana

Transformation Strategy Lead

Washington, DC · On-site +1

... payer, provider, or insurance preferred), with involvement in strategy, operations, or ... Remote NY will be considered, preferred is DC Metro and Louisville, KY. Travel : Occasional travel ...

Humana

Transformation Strategy Lead

Washington, DC · On-site +1

... payer, provider, or insurance preferred), with involvement in strategy, operations, or ... Remote NY will be considered, preferred is DC Metro and Louisville, KY. Travel : Occasional travel ...

Humana

Transformation Strategy Lead

Washington, DC · On-site +1

... payer, provider, or insurance preferred), with involvement in strategy, operations, or ... Remote NY will be considered, preferred is DC Metro and Louisville, KY. Travel : Occasional travel ...

Dorr Agency

Be Seen First

Life Insurance Agent

Alexandria, VA · Remote

$60K - $110K/yr

Licensed Life Insurance Agent (Remote) - Advanced Markets | High Paying | Forbes Ranked We are ... strategies using life insurance , annuities , and retirement solutions . You'll act as a trusted ...

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Remote Payer Strategy information

What is a Remote Payer Strategy role?

A Remote Payer Strategy role involves developing and implementing plans to manage relationships with healthcare payers, such as insurance companies and government programs, from a remote location. Professionals in this position analyze payer trends, negotiate contracts, and ensure that healthcare services are reimbursed efficiently and accurately. They collaborate with internal teams and payers to optimize reimbursement rates and compliance, while working remotely to provide flexibility and broader geographic reach. The position typically requires knowledge of healthcare reimbursement, payer policies, and strong analytical and communication skills.

What are the key skills and qualifications needed to thrive as a Remote Payer Strategy professional, and why are they important?

To excel in Remote Payer Strategy, you need a strong understanding of healthcare reimbursement models, payer contract negotiation, and data analysis, typically supported by a degree in healthcare administration, business, or a related field. Familiarity with payer management systems, claims processing software, and sometimes certifications like Certified Professional in Healthcare Quality (CPHQ) are highly valued. Exceptional communication, strategic thinking, and relationship-building skills set professionals apart in this role. These skills ensure the effective development and execution of reimbursement strategies that optimize revenue and maintain positive payer relationships in a remote environment.

What is the difference between Remote Payer Strategy vs Remote Healthcare Analyst?

AspectRemote Payer StrategyRemote Healthcare Analyst
Required CredentialsBachelor's degree in healthcare, business, or related field; experience in payer or insurance industryBachelor's or master's in healthcare, statistics, or related field; analytical skills
Work EnvironmentFocus on payer strategies, insurance plans, and reimbursement modelsData analysis, reporting, and healthcare data interpretation
Employer & Industry UsageInsurance companies, healthcare payers, healthcare consulting firmsHealthcare providers, research organizations, consulting firms

Remote Payer Strategy professionals focus on developing and implementing strategies related to insurance reimbursement and payer relationships, while Remote Healthcare Analysts analyze healthcare data to inform decision-making. Both roles require healthcare knowledge but differ in their core functions and industry focus.

How does a Remote Payer Strategy professional typically collaborate with cross-functional teams to achieve organizational goals?

As a Remote Payer Strategy professional, you will routinely collaborate with teams such as sales, marketing, medical affairs, and data analytics to develop and execute market access strategies. This collaboration often involves virtual meetings, sharing payer insights, and aligning on tactics to optimize reimbursement and formulary inclusion. Effective communication and adaptability are essential, as you’ll bridge the needs of internal stakeholders with payer expectations, ensuring that the organization’s products gain and maintain favorable access in a dynamic healthcare landscape.
What are the most commonly searched types of Payer Strategy jobs in Washington? The most popular types of Payer Strategy jobs in Washington are:
What are popular job titles related to Remote Payer Strategy jobs in Washington? For Remote Payer Strategy jobs in Washington, the most frequently searched job titles are:
What job categories do people searching Remote Payer Strategy jobs in Washington look for? The top searched job categories for Remote Payer Strategy jobs in Washington are:
What cities in Washington are hiring for Remote Payer Strategy jobs? Cities in Washington with the most Remote Payer Strategy job openings:
Remote Payer Strategy jobs near you
Director, Payer Contracting (MA & Medicaid)

Director, Payer Contracting (MA & Medicaid)

Aledade

Arlington, VA • Remote

Full-time

Posted 15 days ago

Aledade rating

8.6

Company rating: 8.6 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

51st of 487 rated business services

Job description

The Director, Payer Contracting, MA & Medicaid on the Strategic Payer Partnerships team will execute Aledade’s Medicare Advantage and Medicaid value-based care contracts with national and regional health plans as we help primary care providers shift into value-based care. The role will be focused on negotiating value-based care contracts with health plans for their Medicare Advantage and Medicaid members. This role will report to the VP, MA & Medicaid Contracting.
 
We are flexible with respect to geographic location, and the ideal candidate will be comfortable working remotely/work from home within the US or be based from Bethesda, MD office.
 
Primary Duties:
Negotiation & Strategy:
  • Negotiate and renegotiate MA & Medicaid value-based care contracts with prospective payer partners
  • Proactively engage with payer partners to set and/or improve contract terms
  • Collaborate with Senior Leadership to qualify and source market growth and expansion for multi-year risk arrangements
Contract Management & Reporting:
  • Communicate with key, internal stakeholders to ensure a smooth and timely implementation of negotiated terms
  • Read, draft contract language, and track deliverables to ensure compliance and consistency; Compile data and report updates
  • Develop and maintain a deep knowledge of existing MA & Medicaid contract terms and act as the internal expert for contract questions
Relationship Management:
  • Build and manage relationships with payers and other key stakeholders to resolve issues, optimize performance, and identify new opportunities for collaboration.
Minimum Qualifications:
  • Bachelor’s degree
  • 12+ years in healthcare with health plans or provider groups working on contract negotiations within value-based care
  • Results-oriented with the ability to exercise influence to achieve goals rather than control
  • Proven track record of creating, maintaining, and enhancing relationships and communicating effectively with senior management
  • Exceptional attention to detail in contractual language and processes
  • Expert sales, business development, growth professional at local and national level
  • Passionate about driving the shift from fee-for-service to value based care
Preferred Qualifications:
  • Master’s degree or other advanced degrees in management, health services research, health and/or public policy, or other relevant fields 
Physical Requirements:
  • Prolonged periods of sitting at a desk and working on a computer.
#LI-KC1

Who We Are:
Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.

What Does This Mean for You?
At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.

In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:

Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options
And much more!

At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.

Privacy Policy: By applying for this job, you agree to Aledade's Applicant Privacy Policy available at  https://www.aledade.com/privacy-policy-applicants

We may use automated tools, including artificial intelligence (AI), to help organize and evaluate application materials. These tools support our recruiters and hiring managers by helping manage large applicant pools. Human judgment plays an essential role in our hiring process, including in the oversight and use of any automated tools. If you would like more information about our screening and hiring process, please contact us.

What Aledade employees say

Pay

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Aledade

Sourced by ZipRecruiter

Aledade is a leader in population health that is using innovative, value based solutions to transform the way physicians interact with their patients. We are on a mission to change healthcare for the better and solve complex problems within the healthcare system. We follow the simple but radical idea that Aledade only succeeds when our partner practices succeed. From our cutting-edge technology platform to practice transformation services, we provide physicians with everything they need to create and run an accountable care organization (ACO), revamping the way they practice and getting them back to where they should be: quarterbacking their patients' health care! Our customized solutions help clinicians in communities across America preserve their autonomy, deliver better care to their patients, reduce overall costs, and keep independent physician practices flourishing.

Industry

Health care and social assistance

Company size

501 - 1,000 Employees

Headquarters location

Bethesda, MD, US

Year founded

2014

View All Aledade Jobs