Senior VP of Payer Strategy & Market Access

At Pediatric Home Service, we help medically complex kids live their best lives,
at home, with their families. As a national leader in pediatric home care, we offer a full range of services including infusion, clinical nutrition, respiratory therapy, PPEC, private duty nursing, and DME. Whether you're caring for patients or supporting behind the scenes, every role at PHS makes a difference. Join a mission-driven team that’s committed to putting children and families first.

• Position:
  Senior VP of Payer Strategy & Market Access
• Location:
  
  Roseville, MN
• Hours:
  
  Monday-Friday, 8am-5pm

The Senior Vice President (SVP), Payer Strategy & Market Access provides executive leadership to advance Pediatric Home Services' market position through strategic payer relationships and comprehensive contract networks. This leader develops and executes a national payer strategy aligned with PHS’s clinically driven care model for medically complex pediatric populations, ensuring complete and competitive networks across all markets. The SVP negotiates above-market reimbursement rates that reflect the intensity and quality of services delivered and advances innovative payment models tailored to pediatric complexity, while building national and regional partnerships that support long-term growth.

Working in close collaboration with Advocacy, Legal, Finance, Operations, Executive leadership, and Revenue Cycle, the SVP aligns contract strategy with enterprise objectives, ensures leaders are informed of payer developments impacting service delivery and financial performance, and resolves escalated reimbursement and payment integrity issues. Serving as the executive face to commercial and managed care payers, this role ensures contract structures, policies, and payment methodologies reflect the unique needs of the pediatric population PHS serves.

• Provides executive oversight and strategic leadership to a team of Vice Presidents, Payer Relations, setting enterprise priorities, driving performance accountability, and ensuring consistent execution of payer engagement initiatives across all markets.
• Develops and executes a national payer strategy designed to secure complete contract networks in all current and expansion markets.
• Advances PHS’ competitive position by negotiating reimbursement rates that exceed market averages and appropriately reflect clinical complexity, intensity of service, and quality outcomes.
• Positions PHS’ comprehensive, clinically driven care model as differentiated and essential within payer networks.
• Establishes and maintains national payer relationships to ensure consistency in contract structure, rate methodology, and payment policy.
• Designs and implements innovative payment arrangements, including value-based or alternative reimbursement models, aligned with pediatric population complexity.
• Ensures payer contracts include terms and policies tailored to medically complex pediatric populations, including coverage criteria, authorization parameters, and documentation standards appropriate to care intensity.

• Oversees the full payer contract lifecycle to ensure competitive, strategically aligned agreements that strengthen PHS’ market position.
• Leads complex negotiations including reimbursement methodology, rate escalators, pediatric-specific payment policies, network adequacy strategy, and innovative payment models.
• Secures contract language that reflects the unique clinical needs of medically complex pediatric patients.
• Ensures PHS maintains complete and strategically advantageous network participation in all service areas.
• Partners with Finance to model rate scenarios and evaluate financial impact of proposed contract terms.
• Partners with Legal to structure enforceable and strategically favorable contract provisions.

• Partners with Revenue Cycle leadership to resolve escalated payer issues impacting reimbursement, denials, or operational performance.
• Monitors payer trends, payment accuracy, and denial patterns to identify systemic concerns.
• Implements corrective strategies in collaboration with internal…