Payer Strategy & Partnerships Lead

Responsibilities

Strategic Ownership

• Lead payer expansion strategy by identifying which health plans to pursue each quarter based on market size, reimbursement rates, member demographics, and strategic fit.
• Negotiate contract terms with health plans on reimbursement rates, credentialing requirements, claims processes, and payment timelines.
• Create repeatable processes for how Loula identifies, launches, and scales payer partnerships.
• Present quarterly payer strategy recommendations to leadership including contract priorities, revenue projections, and risk assessments.

Payer Operations

• Own plan launch operations for every new contract, including mapping out launch timelines and action items, coordinating with Product, Engineering, and Operations.
• Work with Candid Health on EDI/EFT enrollments and manage internal and external communications.
• Create and maintain an internal "Payer Playbook": comprehensive documentation for all 20+ health plans covering contract nuances, reporting and billing requirements, credentialing processes, fee schedules, and key contacts.

Relationship Building & Management

• Serve as the primary point of contact for 20+ Medicaid and commercial payer organizations, building collaborative and growth-oriented relationships.
• Conduct regular check-ins with key payer contacts to review performance, identify opportunities for deeper collaboration, and explore pilot programs or expanded partnerships.
• Navigate payer organizations to identify and build relationships with the right stakeholders across credentialing, provider relations, network development, and population health.
• Advocate for Loula in contract discussions and partnership development.

Cross-Functional Collaboration

• Support the Provider Success team with developing onboarding resources.
• Serve as the voice of payer dynamics internally — sharing trends, friction points, and opportunities with Product, Engineering, Provider Success, and Revenue Cycle.
• Enable Credentialing and Revenue Cycle teams with payer-specific guidance.

Requirements

• 4-8 years of experience in healthcare payer relations, payer contracting, healthcare go to market, provider network management, or healthcare operations.
• Managed external partnerships or stakeholder relationships with professionalism and strong follow-through.
• Built workflows, documentation, and systems to increase visibility and help teams scale.
• Collaborated across functions to solve problems and drive improvements.
• Navigated complex organizations with competing priorities and multiple stakeholders.
• Negotiated contracts, agreements, or terms (preferred experience in the California market).
• Been an operator on a founding team or early employee at a startup.

Compensation & Benefits

• $150,000+ annual salary
• Generous equity package
• Unlimited PTO
• Medical, dental, and vision coverage - FSA & HSA options
• Access to One Medical, Talkiatry, Peloton, Kindbody, and more
• Short & Long term disability insurance, Life insurance