SVP, Payor Strategy

• Pay or shift range: $240,000 USD to $300,000 USD The estimated range is the budgeted amount for this position. Final offers are based on various factors, including skill set, experience, location, qualifications and other job-related reasons.

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.

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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:

• 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…