SVP Managed Care & Payer Solutions

Job Summary

Reporting to the EVP, Chief Financial Officer, the Senior Vice President (SVP) of Managed Care and Payer Solutions is an enterprise-level leader responsible for shaping BSWH’s strategy and performance across commercial payers, government payers, value-based care (VBC) arrangements, and employer-based offerings.

• This role serves as the system’s strategic architect for payer and customer value creation-integrating strategy, pricing, analytics, network performance, and operations to improve affordability, quality, access, and the overall customer experience.
• The SVP drives strategic direction, growth, and operational performance for payer initiatives while partnering closely with Care Coverage leadership on employer offerings and VBC arrangements, and with the System CFO and other enterprise leaders on value and long-range financial planning.
• A critical component of the role is leading enterprise progress on the company-level Objective and Key Result (OKR) for clear and consistent pricing, aligning contracting, product design, revenue cycle, and market strategy.
• The SVP also advances BSWH’s payer analytics maturity in close partnership with the Revenue Analytics / Revenue Intelligence Unit (RIU) to enable payer-level insights that strengthen contract performance, negotiation strategy, and enterprise financial predictability.
• The SVP partners closely with the BSWH Quality Alliance and Direct-to-Employer (DTE) teams to deliver one integrated, enterprise-wide value delivery model.

• Lead and manage payer, employer (in close partnership with the SVP Care Coverage), and pricing strategy functions.
• Serve as the system’s strategic architect for payer value creation and ensure alignment with BSWH’s enterprise strategy and long-range financial plan.
• Drive execution on multi-year strategic roadmaps with priority payers and ensure cross-functional alignment across contracting, product, revenue cycle, market strategy, and operations.
• Work effectively in a highly matrixed environment (including Care Coverage leaders such as Employer Solutions Portfolio leadership) to align VBC contracting, DTE initiatives, and related digital/operational enablers.

• Cultivate enterprise-level, high-impact strategic partnerships with key commercial and government payers.
• Reduce administrative friction, improve administrative efficiency, and enhance customer/member/employer experience through end-to-end payer collaboration.
• Deliver measurable value through joint operating models, service-level expectations, and shared performance goals.

• Serve as executive owner of the enterprise OKR for clear and consistent pricing.
• Establish and sustain pricing governance and discipline across payer, employer, and VBC solutions.
• Integrate pricing strategy into payer negotiations, product design, and market strategy to improve transparency and predictability.

• Oversee growth and expansion of payer relationships and products, including VBC components within payer arrangements.
• Partner with Care Coverage leadership to shape DTE opportunities and drive pricing and growth for employer product lines.
• Identify and execute new contracting and partnership opportunities that advance enterprise value and market position.

• Create and support unified strategies across payer, accountable care/ACO, Quality Alliance, and DTE teams.
• Partner with ACO leadership to optimize risk models and performance across risk-bearing arrangements.
• Co-design employer products and value propositions with DTE and Care Coverage partners to deliver an integrated value delivery model.

• Expand and optimize managed care partnerships across all market segments.
• Advance VBC strategy and execution in close coordination with Care Coverage leadership and relevant product leaders to ensure clear communication of VBC terms and operational readiness for performance.

• Oversee financial outcomes for payer and employer contracts, including VBC contract components.
• Ensure rate adequacy, contract governance, and disciplined performance management against established key performance indicators (KPIs).
• Engage routinely with Care Coverage and other operational leaders (including third-party risk product leadership) to align contract terms with delivery system execution and performance.

• Advance payer analytics maturity with the Revenue Analytics / RIU teams to deliver sophisticated payer-level insights.
• Strengthen negotiation insights, rate yield analysis, contract compliance monitoring, and enterprise financial predictability through data-driven decision-making.

• Lead…