Market VP Payer Strategy Network Management, SoCal

As our Market Vice President of Managed Care and Payer Strategy Southern California you will serve as a pivotal leader responsible for executing enterprise-level payer and contracting strategies across the Southern California market. Reporting to the Regional Vice President you will spearhead local managed care initiatives foster strategic payer partnerships and drive network performance. Your leadership will be instrumental in aligning local contract execution clinical integration and value-based care objectives with the broader mission of CommonSpirit Health to ensure market competitiveness and operational excellence.

Every day you will oversee the negotiation administration and performance monitoring of complex payer agreements spanning Medicare Advantage Managed Medicaid Marketplace and Commercial product lines. You will lead cross-functional collaboration with operational leaders ACO/CIN partners and Value Hubs to optimize funds flow models and value-based care outcomes. Additionally you will act as a primary liaison between the market and internal departmentsincluding Finance Revenue Cycle Legal and Regulatoryto resolve AR performance issues manage denials and ensure that every contract reflects current market realities.

To be successful in this role you will possess a deep understanding of the Southern California healthcare landscape and proven expertise in managed care contracting and payer relations. You will be a strategic communicator capable of navigating complex regulatory environments and facilitating high-level joint operating committees. Candidates should demonstrate a strong track record of partnering with revenue cycle teams to improve financial performance alongside a forward-thinking approach to advancing population health and network development within an integrated health system.

Key Responsibilities:

• Contract Negotiation & Execution: Support enterprise-wide managed care contracting (Medicare Medicaid Commercial Marketplace) by providing reimbursement modeling and ensuring alignment with regional financial goals.
• Payer & Network Relationship Management: Serve as the primary point of contact for local payers leading Joint Operating Committees to resolve operational issues and ensure strict contract adherence.
• Value-Based Care Performance: Partner with local Value Hubs (ACO/CIN) to implement value-based payment arrangements and monitor success through cost and quality performance reporting.
• Population Health Integration: Collaborate with clinical and population health teams to align payer contracts with care management initiatives and drive continuous performance improvement.
• Revenue Cycle & Operational Optimization: Partner with Revenue Cycle teams to proactively address denials underpayments and aging AR implementing payer-specific solutions to improve operational efficiency.
• Strategic Market Alignment: Monitor local market dynamics and payer product shifts to inform regional strategy while coordinating with legal finance and advocacy stakeholders to ensure organizational compliance and brand alignment.

Required:

• Bachelors degree from an accredited college or university in healthcare administration business administration or other discipline related to the duties of the position.
• Minimum of ten (10) years of progressive managerial and strategic leadership combined experience in payer/provider strategy/managed care and population health that would demonstrate attainment of the requisite job knowledge/abilities.
• Minimum of five (5) years leadership/management experience
• Minimum of three (3) years direct strategic health care delivery and/or population health networkleadership/management experience.

Preferred:

• Masters degree

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nations largest nonprofit Catholic healthcare organizations CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2300 clinics care sites and 137 hospital-based locations in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157000 employees 45000 nurses and 25000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care community benefits and unreimbursed government programs. Together with our patients physicians partners and communities we are creating a more just equitable and innovative healthcare delivery system.