Head of Payor Strategy

Posted 9 Days Ago
Be an Early Applicant
Hiring Remotely in USA
Remote
Mid level
Healthtech
The Role
Own the payor strategy, build relationships with health plans, negotiate contracts, and develop payor infrastructure and analytics. Collaborate with clinical, finance, and product teams to enhance service offerings in home-based care.
Summary Generated by Built In

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.

The opportunity:

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.

What you'll do:

  • 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:

  • Competitive compensation packages that reflect the value you bring. We reward our team for the impact of their work – full-time employees are eligible for an annual company performance bonus.

  • Comprehensive health coverage that works for you. Choose from high-quality medical dental and vision options, including a $0 deductible PPO and a company-funded HSA, alongside employer-paid life and disability insurance.

  • Generous paid time off. We provide policies that allow you to recharge along with 10 paid company holidays.

  • Financial savings benefits to support your future. We support your financial well-being with HSA contributions, optional FSA and commuter benefits, and full coverage of all 401(k) account fees (employer match not currently offered).

  • Paid parental leave to support your growing family. We provide paid leave, so you can focus on bonding and adjusting to life as your family grows.


We are an equal opportunity employer and welcome applicants from all backgrounds, consistent with applicable laws. Employment is contingent upon successful completion of a background check, satisfactory references, and any required documentation.

Our Values
  1. Families First
    Redefining healthcare starts with how we treat the parents and children we serve. We go above and beyond for every family, building strong, lasting relationships. We continually ask ourselves, “Would we want this for our own families?”

  2. Urgency with Precision
    Millions of families are waiting for care, and they cannot wait, therefore this is not your typical 9 to 5 job. We match their urgency with our own, delivering exceptional care without compromise. Here, speed and excellence go hand in hand.

  3. Relentlessly Resourceful
    As an ambitious startup, we adapt quickly and make the most of limited time and resources. We solve challenges with creativity to deliver results without unnecessary complexity.

  4. Purpose with Positivity
    We take our mission seriously while never losing sight of the people behind the work. Respect, kindness, memes, and coffee make us stronger as a team and better for the families we serve.

  5. Driven to Redefine What’s Possible
    We are here to make healthcare better, which means asking hard questions, challenging outdated systems, and finding smarter, more compassionate ways to deliver care.

Skills Required

  • Experience setting health plan strategy or in commercial roles like Director of Payor Strategy
  • Track record of negotiating and closing contracts with Medicaid, Medicare, or commercial insurers
  • Fluency in contracting and performance measurement in healthcare
  • Understanding of home-based care regulatory and environmental factors
  • Ability to collaborate across teams and manage strategic relationships
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The Company
HQ: San Francisco, CA
254 Employees

What We Do

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.

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