Partnership Development Manager - Payors / Health Plans

About the role

Ophelia Health is seeking a full-time Partnerships Manager to initiate and develop strong, lasting relationships with health plans (payors) to support members with opioid use disorder (OUD). In this role, you will be the strategic link between our organization and our payor partners, focusing on activating utilization and integrating workflows to drive member access. This role is focused on scaling partnerships with health plans (payors) to drive member access to Ophelia's virtual MOUD services. You will work closely with care management, case management, and behavioral health teams within health plans to ensure members with OUD are identified and connected to care. Your mission is to translate health plan partnerships into consistent, high-quality member referrals and improved treatment engagement. Join Ophelia Health to not only build a career but to make a meaningful impact on one of the greatest healthcare crises of our lifetime. You'll be part of a passionate team, with ample opportunities for growth, competitive benefits, and the chance to truly make a difference in people's lives.

Responsibilities

• Build and manage relationships with key stakeholders across health plans, including:
• Case managers and care coordinators
• Behavioral health teams
• Population health and care management leadership
• Serve as the day-to-day partner ensuring Ophelia is top-of-mind for appropriate member referrals
• Design and implement referral pathways within health plan workflows to connect members to Ophelia
• Partner with external care management teams to:
• Embed Ophelia into case manager workflows and escalation pathways
• Ensure smooth referral processes (warm handoffs, clear eligibility criteria, simple intake)
• Drive adoption by making referrals easy, repeatable, and aligned with plan operations
• Monitor referral trends and proactively engage case managers to increase appropriate referrals
• Identify gaps in utilization and implement targeted strategies to improve performance
• Educate health plan teams on:
• Ophelia's clinical model and outcomes
• When and how to refer members
• The value of MOUD in reducing total cost of care and improving outcomes
• Position Ophelia as a trusted extension of the plan's care management strategy
• Track and analyze:
• Referral volume by plan and team
• Conversion from referral → patient entering care
• Engagement and retention metrics
• Use data to:
• Identify high- and low-performing partners
• Adjust outreach and engagement strategies
• Report back to internal and external stakeholders on performance

Requirements

• 2-5+ years of Health plan experience: Experience working with or within health plans (Medicaid managed care strongly preferred), with exposure to payor partnerships, care management/case management programs, or behavioral/population health
• Utilization-focused operator: Proven ability to drive utilization and engagement within existing partnerships (not just close deals)
• Health plan fluency: Strong understanding of health plan operations, including case management workflows, member engagement challenges, and behavioral health care coordination
• Stakeholder influence: Ability to engage and influence non-sales stakeholders (e.g., case managers, care coordinators, behavioral health teams) and build trust across clinical and operational teams
• Data-driven execution: Highly analytical and comfortable using data to track performance, identify gaps, and adjust strategy to drive results
• Operator mindset: Focused on execution, adoption, and measurable outcomes vs. just relationship-building
• Cross-functional communicator : Able to translate between clinical care, payor priorities, and member needs to drive alignment and action
• Mission-driven: Passionate about improving access to care for high-need, underserved populations
• Proven ability to maintain professionalism and confidentiality when working with sensitive and confidential information
• Ability to travel periodically for partner visits
• Preferred :
• Medicaid or dual-eligible populations

Benefits

Additional Information

Are you looking for a role in a company that's solving one of the greatest challenges of our lifetime? Ophelia helps people end their opioid use and restore their quality of life with respect for their time and dignity. Our mission is to make evidence-based treatments for opioid use disorder (OUD) accessible to everyone... and we're looking to bring more people onto our team to help us achieve it. Ophelia is a venture-backed, healthcare startup that helps individuals with OUD by providing FDA-approved medication and clinical care through a telehealth platform. Our approach is discreet, convenient, and affordable. We've been successfully operating in 14 states for almost six years and we're excited to continue our growth. We are a team of physicians, scientists, entrepreneurs, researchers and White House advisors, backed by leading technology and healthcare investors working to re-imagine and re-build OUD treatment in America.

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