Payer Lead, Medicaid

Babylist Inc.

Job Overview

Location

United States

Job Type

Full-time

Full Job Description

📋 Description

• Babylist is seeking a highly motivated and experienced Payer Lead – Medicaid to spearhead our end-to-end Medicaid contracting strategy and execution. This pivotal role is instrumental in unlocking one of Babylist Health's most significant growth opportunities by securing essential state Medicaid licenses and Managed Care Organization (MCO) contracts. Your primary objective will be to expand Babylist Health's presence across high-birth-volume states, cultivating robust and durable payer relationships that will underpin our long-term scalability and success in serving growing families.
• In this strategic position, you will collaborate closely with the General Manager (GM) to define and refine the overarching Medicaid market strategy. You will then be entrusted with the full responsibility for executing this strategy from inception to completion. Your scope of work will encompass a wide range of critical activities, including the meticulous prioritization of state license applications, the proactive driving of direct contracting initiatives with MCOs, and the cultivation of vital external relationships with key stakeholders. This includes building rapport with state Medicaid agencies, influential trade associations, payer executives, and regulatory bodies, all of which are crucial for navigating and succeeding in competitive Medicaid markets.
• A core component of your role will be to own and drive the Medicaid expansion roadmap. This involves a strategic approach to state prioritization, determining the optimal sequencing for acquiring necessary licenses, and setting ambitious yet achievable MCO penetration targets. You will be instrumental in developing and executing a comprehensive strategy designed to access a significant portion of U.S. births covered by Medicaid, with a particular emphasis on populous and high-impact states such as California, Texas, and New York. Your efforts will be directly linked to modeling the revenue impact, financial timing, and return on investment (ROI) of these critical Medicaid expansion initiatives, working in close partnership with the GM, Finance, and other senior leadership.
• You will take the lead in navigating the complex landscape of state licensing and regulatory requirements. This will involve close collaboration with external consulting partners to ensure the timely, compliant, and scalable submission of state Medicaid Durable Medical Equipment (DME) license applications. A key responsibility will be to anticipate, understand, and adeptly navigate the unique regulatory complexities, bureaucratic hurdles, and specific documentation demands inherent in each state's licensing process. You will serve as the primary, senior-level point of contact for all interactions with state Medicaid agencies, licensing bodies, and other relevant regulators, ensuring clear communication and efficient progress.
• Furthermore, you will be responsible for leading and managing direct MCO contracting efforts. This encompasses the entire lifecycle of contract acquisition, from initial outreach and strategic engagement to rigorous negotiation and ongoing relationship management. You will proactively build a robust pipeline of promising opportunities by leveraging your existing network within trade associations, actively participating in industry events, and cultivating strong connections within payer networks to accelerate contract wins. Your negotiation expertise will be vital in securing favorable contract terms that strike an optimal balance between market access, operational feasibility, and sustainable long-term profitability.
• This role demands exceptional cross-functional collaboration. You will be tasked with establishing and refining scalable processes, developing comprehensive playbooks, and defining best practices for Medicaid contracting. You will work hand-in-hand with our Operations, Billing, Legal, and Product teams to ensure that all newly secured Medicaid contracts are seamlessly integrated, fully compliant, and operationally ready to serve our customers. A critical aspect of this collaboration is ensuring that the expansion of Medicaid coverage does not adversely affect key performance indicators such as denial rates, accounts receivable (AR), or the overall patient experience.
• Your success will be measured by tangible outcomes, including the number of new state Medicaid licenses secured, the volume and diversity of MCO contracts executed, the percentage of the total U.S. Medicaid birth population made accessible through our services, the efficiency of transitioning from license approval to MCO contract activation, and the direct revenue contribution generated from these Medicaid contracts.
• Babylist is a remote-first company that thrives on connection and impact. We believe in working with focus and intention, then stepping away to recharge. We are committed to exceptional management, investing in tools and opportunities that foster strong colleague relationships. You will be part of building products that positively impact millions of people's lives, with AI intentionally embedded in our workflows to support innovation and amplify our impact. We offer competitive pay, meaningful opportunities for career advancement, and a belief that technology and data are key to solving complex problems. We are dedicated to your career progression and performance-based advancement.

🎯 Requirements

• 6–8+ years of experience in payer contracting, with deep expertise in Medicaid and Managed Care Organizations (MCOs).
• Proven track record of successfully securing state licenses and negotiating MCO contracts.
• Strong existing relationships with Medicaid agencies, MCOs, and relevant industry trade groups.
• Comfort and demonstrated ability to operate effectively within complex regulatory environments.
• Ability to be hands-on and meticulously manage contract details to ensure rapid and compliant activation.

🏖️ Benefits

• Competitive salary with equity and bonus opportunities.
• Company-paid medical, dental, and vision insurance.
• Retirement savings plan with company matching.
• Generous paid parental leave and PTO.
• Remote work stipend to set up your home office.

Skills & Technologies

Senior

Remote

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Babylist Inc.

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About Babylist Inc.

Babylist operates an online baby registry platform that lets expectant parents add items from any retailer, book services, and create cash funds. It aggregates products across major stores, offers a universal registry browser button, and provides personalized checklists. The company also sells its own line of baby merchandise, including nursery furniture, strollers, and accessories, through its e-commerce storefront. Headquartered in Oakland, California, Babylist supports parents with expert guides, product reviews, and a mobile app for managing registries, tracking gifts, and coordinating shipping to recipients.

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