SVP, Payor Strategy

Axia Women's Health is the nation's largest community-based, integrated women's health network, serving women throughout New Jersey, Pennsylvania, Indiana, and Kentucky. At its core, Axia Women's Health is a community of more than 400 providers across nearly 150 locations committed to delivering a more caring, connected, and progressive healthcare experience for women. Its rapidly growing network spans OB/GYN care, breast health, high-risk pregnancy care, urogynecology, behavioral health, fertility, imaging, and laboratory services.

As a leading physician-led women's healthcare platform, Axia partners with affiliated physician practices to drive clinical excellence, operational performance, and sustainable growth. Together, Axia Women's Health puts women first by delivering the personalized care women need to lead healthier, happier lives. Axia Women's Health has been recognized as the #1 Physician Practice for Women's Health by Castle Connolly and certified as a Great Place to Work for five consecutive years. Learn more at www.axiawh.com.

The SVP, Payor Strategy leads payor contracting on behalf of Axia Women's Health's affiliated physician practices across a growing multi-state MSO platform. Responsible for both fee-for-service (FFS) and value-based care (VBC) arrangements, this executive will develop and execute enterprise payor strategy across commercial, Medicare Advantage, and Medicaid managed care plans.

Axia currently operates in New Jersey, Pennsylvania, Indiana, and Kentucky and continues to expand. Reporting to the Chief Growth Officer, the SVP will lead market expansion contracting efforts, support M&A activity from diligence through integration, and serve as a strategic advisor to executive leadership, Finance, Revenue Cycle, Operations, and physician leaders.

The ideal candidate is a strategic and influential healthcare executive with deep expertise in provider contracting, reimbursement strategy, and payor negotiations, coupled with the ability to build strong relationships across physician, executive, and health plan stakeholders.

Essential Functions:

Payor Strategy

• Develop and carry out a multi-year payor strategy across commercial, Medicare Advantage, and Medicaid managed care plans that supports Axia's growth and financial goals.

• Lead contracting on behalf of the affiliated professional corporations (PCs) within the MSO model, in keeping with corporate practice of medicine requirements and Axia's governance structure.

• Assess market dynamics, payor behavior, and competitive positioning in current and target markets to set contracting priorities.

Fee-for-Service Contract Optimization

• Lead negotiations, renewals, and amendments of FFS agreements to improve rates, strengthen contract terms, and reduce administrative burden.

• Build contract strategies for each service line, including professional, imaging, and laboratory fee schedules, and address prior authorization, site-of-service, and ancillary billing terms specific to each.

• Manage escalations, disputes, and termination strategy when payor performance falls short of expectations.

• Work with Revenue Cycle and Finance to monitor contract compliance, identify underpayments, and reduce reimbursement leakage.

Value-Based Care & Alternative Payment Models

• Design, negotiate, and expand VBC arrangements, including quality incentive programs, shared savings, care management fees, and other alternative payment models suited to women's health.

• Model the financial and operational impact of proposed arrangements and recommend which structures to pursue.

• Partner with clinical and operational leaders to track performance against quality, utilization, and cost benchmarks and capture earned incentives.

Market Expansion & New Arrangements

• Structure payor arrangements for new markets and new service lines, including network participation strategy, rate positioning, and contracting timelines.

• Build relationships with health plan leadership in current and expansion markets.

M&A Support

• Lead payor diligence on prospective practice acquisitions and affiliations in new markets, including contract review, rate benchmarking, assignment and change-of-control provisions, and reimbursement risk.

• Partner with Revenue Cycle Management to guide payor onboarding of newly affiliated practices.

• Provide reimbursement assumptions and synergy estimates to support deal modeling and integration planning.

Analytics, Reporting & Executive Partnership

• Maintain payor performance scorecards covering rates, contract profitability, VBC performance, and denial trends.

• Present findings and recommendations to the Chief Growth Officer, executive leadership, physician leadership, and the Board.

• Monitor federal and state reimbursement policy, CMS rulemaking, and payor policy changes and advise on business implications.

Supervisory Responsibilities:

• Manages a small team that supports contracting and payor analytics

Skills

• Expert command of commercial, Medicare Advantage, and Medicaid managed care contracting and reimbursement methodologies.

• Proven leadership ability, including building, developing, and holding accountable a lean, high-performing team.

• Demonstrated success negotiating both FFS rate improvements and VBC arrangements for provider organizations.

• Strong financial modeling and analytical skills, with the ability to turn contract economics into clear executive recommendations.

• Thorough understanding of MSO and PC structures, including how payor contracting works within them.

• Working knowledge of revenue cycle, credentialing, and physician practice operations as they relate to reimbursement performance.

• Executive presence and strong relationship skills with health plan leadership, physicians, and deal teams.

• Ability to work independently and deliver results in a fast-growing, private equity-backed environment.

Experience and Education:

Required

• Bachelor's degree required.

• 12+ years of payor contracting, managed care, or reimbursement strategy experience, with significant provider-side experience.

• Experience contracting for a multi-site physician group, MSO, practice management organization, or ambulatory provider platform.

• Proven record of leading complex, multi-payor negotiations at the executive level.

Strongly Preferred

• Experience in an MSO or private equity-backed physician practice management environment.

• Experience supporting M&A diligence and post-close integration of physician practices.

Preferred

• Payor contracting experience and established health plan relationships in New Jersey, Pennsylvania, Indiana, and/or Kentucky.

• Experience in women's health or related specialties such as MFM, urogynecology, breast imaging, or laboratory services.

• Payor-side experience in network management or provider contracting.

• MBA, MHA, MPH, JD, or related advanced degree.

Salary Range: $240k to 330k

The estimated salary range represents the budgeted compensation for this position. Final offers are determined based on a variety of factors, including experience, qualifications, skills, internal equity, geographic location, and other business considerations.

Full Time Benefits Summary

• Full time benefit-eligibility beginning the first of the month after hire

• 401(k) with company match

• Generous PTO offering with additional time off for volunteering

• Choice of multiple medical insurance plans to best meet your needs

• Access to Axia providers at little to no cost through Axia’s medical insurance

• Axia-paid life insurance, short term and long term disability

• Free counseling for colleagues and family members, including parents and parents-in-law

• Access to discount on Hotels, Theme Parks, Gym Memberships, and more through the Great Works Perks Program

• Additional insurance options including dental, vision, supplemental life insurance, FSA, HSA w/ employer contribution, identity theft, long term care, pet insurance and more!

At Axia Women's Health, we're passionate about creating a community where our colleagues and patients feel empowered to be their full, authentic selves. We welcome all individuals without regard to gender, race, ethnicity, ability, or sexual orientation and proudly celebrate our individual experiences and differences.

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and complete the required employment eligibility verification process upon hire. Applicants must be currently authorized to work in the United States on a full-time basis.

Originally posted on Himalayas