About Us:
The United States has the poorest maternal and birth outcomes of all developed countries with underserved, Black, Brown, Indigenous communities disproportionately affected. Cayaba Care is working to drastically improve the experience of affected communities by reimagining how we deliver meaningful and compassionate care to expectant moms.

Cayaba Care's mission is to improve pregnancy, birth and the postpartum journey for women and their families by reimagining how maternity care is delivered. Our team is focused on building trust-based engagement and wrap-around support for expectant moms at home, in person and virtually, to ensure they have all the social support they need for a successful and joyful pregnancy journey. We leverage technology to support our virtual engagement that allows us to meet all our moms where they are.

We ensure that our members do not feel alone during their pregnancy journey, and that they have a trusted resource for support, resources, and information throughout their pregnancy, delivery and well into postpartum. Cayaba Care does not replace the primary obstetrician or doctor’s relationships. Instead, we support expectant mothers with all other support services that are traditionally not available through their doctors’ offices.

Our Values:

• Empathy is at the heart of everything we do. We must always center the experiences of the mothers and families we serve, as well as support and uplift one another.
• Collaboration is what makes us stronger. We achieve the greatest impact when we work together, share knowledge, and elevate each other’s strengths.
• Resilience reflects our ability to push through challenges, adapt in a fast-changing environment, and remain committed to our mission no matter the obstacles.

The Role:

In this highly visible role, the Director of Payer Strategy and Contracting will drive new business growth and ensure ongoing success in our strategic health plan partnerships, while also deepening external payer relationships to identify new product opportunities and drive further alignment. This role is a highly collaborative role across Cayaba’s ELT and SLT teams.

Reporting to and working closely with the Chief Executive Officer, the Director of Payer Strategy and Contracting is responsible for capturing new business opportunities and ensuring partner satisfaction within the healthcare payer sector. This role requires cross functional communication, process management, and collaboration with our Growth, Care Operations, Technology and Finance teams to strategically and successfully partner with Medicaid plans and healthcare systems.

Responsibilities:

Payer Strategy and Contracting

• Plan, develop, direct, coordinate and monitor all activities to successfully bring our product and services to new payers
• Navigate contract strategy, negotiations, and renegotiations to optimize partnership structure and success
• Manage contract negotiations with current and future Medicaid and commercial payers
• Own pricing model and reviewing of unit economics for each contract
• Leverage data to generate insights and identify new opportunities for payer partnership growth
• Collaborate with cross functional, internal stakeholders to deliver insights to inform product operations and strategy
• Evaluate current and potential new geographic areas for new business opportunities
• Oversee policy and regulatory environment and serve as an expert level resource related to business review of all contracts, amendments, and correspondence
• Collaborate with the Finance and Product teams to develop alternative payment models and ensure delivery of engagement and outcome based performance
• Identify opportunities for enhanced relationships, reimbursement, referrals, and a growing market presence
• Prepare forecasts and advise the Executive Leadership Team (ELT) on all matters concerning net revenues in the areas of Medicaid and commercial partnerships

Sales and Business Development

• Drive sales to increase revenue growth with new (and renewed contracts) to expand Cayaba Care’s value-add to healthcare payer clients, and increase overall domain footprint
• Identify and capture add-on, new capability, and cross-sell opportunities to drive sales and revenue growth within the healthcare payer industry
• Work closely with the CEO to explore new sales opportunities and ensure a unified approach to payer partnership and contract management
• Develop and recommend payer pricing, contracting and operational strategies to optimize the long-term financial profitability of the company
• Work closely with the Finance team to evaluate, source, design, recommend, and monitor the execution and effectiveness of processes designed to ensure timely and accurate reimbursement from payers

Qualifications:

• Bachelor’s Degree in business, communications, health administration or a related field required
• MBA or equivalent
• 7+ years experience in healthcare payer strategy or consulting in payer contracting space
• Deep understanding and experience with developing and negotiating payer contracts, particularly for Medicaid MCOs; commercial payer experience is a plus
• Deep network and previously established relationships with Medicaid payers
• Experience with successful value-based contracting options for specialty services with Medicaid or commercial payers
• Excellent written and interpersonal communication skills including active listening, self-management and awareness, emotional intelligence, and a high degree of integrity and professionalism
• Proven financial acumen and ability to identify the impact of changes on budget goals and financial targets
• Experience facilitating buy-in and engagement across diverse stakeholder groups
• Ability to anticipate risks and mitigate effectively
• Proven experience selling to C-level executives nationally
• Proven record of exceeding sales quota
• Experience with Hubspot, Google Suite required
• Experience with Series A - Series C start-ups
• Ability to travel as needed (up to 30%) for meetings and conferences
• Experience in women’s health, pediatrics and specialty populations a plus

At Cayaba Care, we recognize that great talent deserves great rewards. The expected base salary for this position is between $150K-$170K per year, plus commission. The exact compensation will depend on years of relevant experience.