VP, Provider Reimbursement and Contracting

📋 Description

• • The VP, Provider Reimbursement and Contracting is a senior leadership role responsible for architecting and advancing network solutions that integrate network design, payment innovation, and high-performing provider partnerships within a unified medical-pharmacy ecosystem. This role is critical to optimizing total cost of care, improving outcomes, and enhancing value for employers and members by aligning network and product strategies.
• • Day to day, the incumbent will lead the development of differentiated network constructs, tailored ASO network solutions, and high-performing provider contracts with value-based innovations. They will create tools and processes for evaluating network proposals, develop reimbursement methods that reduce provider abrasion, lead value-based payment model design, cultivate strategic provider partnerships, build geographic micro networks, collaborate with product and analytics teams to embed network solutions into offerings, and mentor contracting teams to ensure operational excellence and strategic alignment.
• • The role sits within Judi Health, an enterprise health technology company comprising Capital Rx (a public benefit corporation PBM), Judi Health™ (full-service health benefit management), and Judi® (the Enterprise Health Platform). Together, these entities are rebuilding trust in U.S. healthcare by deploying infrastructure for better care, serving self-insured employers, TPAs, and health plans with integrated, scalable solutions.
• • In this role, the individual will drive strategic innovation in network and payment design, gain deep expertise in value-based care and ASO contracting, lead high-impact provider partnerships across the country, influence enterprise-wide product integration, and shape the future of employer-sponsored healthcare through data-driven, transparent, and automated reimbursement systems.