Head of Payor Strategy
External
Abby-care · San FranciscoPrepare for this interview
EliteAI-generated questions, company research, and talking points tailored to this role
About the role
Payor relationships are the commercial engine of everything we build. Every market we enter, every family we serve, every new service line we launch connects back to a contract with a health plan: Medicaid managed care, Medicare Advantage, or commercial. We are hiring a Head of Payor Strategy to own this function entirely: shaping the partnership strategy, closing contracts, and building the infrastructure that lets us prove and capture value at scale. You will have significant latitude to define how Abby Care expands its payor relationships, enters new markets, and positions itself commercially. You will report directly to Executive leadership and partner closely with clinical, finance, operations, and product. If you are motivated by owning the commercial agenda of a fast-moving company with a real mission, we'd love to talk. Why this role: C-level partnership. Direct access to and collaboration with our CEO and executive team on market strategy, pricing, and expansion decisions. Own the function. You define the strategy, build the relationships, structure the deals, and own the outcomes. Full-spectrum payor portfolio. Medicaid MCOs, Medicare Advantage, and commercial health plans; you will build a program that spans the full continuum of how home-based care gets financed in America today. Clinical partnership. Work alongside our Head of Clinical to design outcomes-based programs that differentiate us in plan conversations and justify superior rates.
Responsibilities
- Own relationships with Medicaid MCOs, Medicare Advantage plans, and commercial health plan partners across current and target markets
- Lead contract negotiations for new market entries, rate increases, and value-based program structures
- Define and execute the company's payor roadmap: which plans to prioritize, on what terms, in what market sequence
- Build the payor infrastructure from the ground up: reporting cadences, performance dashboards, quality tracking, and plan-facing analytics
- Partner with clinical leadership to design and articulate an outcomes story that resonates with what health plans actually care about
- Work with finance to model contract economics, pressure-test rate assumptions, and protect margin at scale
- Represent Abby Care at health plan meetings, state conferences, and industry forums
- What you bring:
- Experience setting an organization's health plan strategy - from the plan side (network strategy, provider contracting, government programs, or consulting) or the operator side (Director/VP Payor Strategy, Head of Commercial, CRO, or equivalent at a digital health company)
- Track record of negotiating and closing contracts with Medicaid MCOs, Medicare Advantage plans, or commercial insurers.
- Fluency in how plans buy, contract, and measure performance: PMPM and FFS rate structures, authorization mechanics, value-based care arrangements, quality frameworks (HEDIS, CAHPS, state-specific KPIs)
- Understanding of the regulatory and contracting environment for home-based care services or a demonstrated ability to develop deep domain expertise quickly
- Ability to work across internal teams (clinical, finance, product, legal) and serve as the connective tissue between what we deliver and what plans will pay for
- We are not tied to a specific title or years of experience. What matters is that you have negotiated and closed consequential deals with health plans and can show the results.
Benefits
Additional Information
About Abby Care Making family care possible. At Abby Care, we are tackling one of the most important and unsolved challenges of our time: family caregiving. Over 50 million Americans are family caregivers for loved ones without pay, tools, or support. Our mission is clear and ambitious: to train and employ family caregivers so they can get paid for the care they already provide at home. Abby Care is building a tech-powered, family-first care platform to efficiently deliver care, improve health outcomes, and provide the best-in-class experience nationwide. We are rapidly expanding our mission and looking for passionate team members to join. Abby Care has partnered with leading insurance plans, healthcare providers, and community organizations. We're supported by top, mission-driven VCs to empower families throughout the country.
Your Match
How well this role fits your profile.
Company Intel
What employees say
Worked at abby-care? Share your experience