Director, Healthcare Business

General Information:

Compensation We Offer 

• The initial compensation for this position ranges from $131,940 - $162,270 annually; depending on experience, location, and internal equity considerations. 

Benefits We Offer 

• Benefits Eligibility starts on day ONE 
• We provide a robust benefits package which includes medical, dental, vision, See our Benefits Page HERE.
• 401K Employer Match up to 4% 
• Competitive Time Off Plans

Must meet eligibility requirements based on employment status 

Overview:

Reporting to the Executive Director of Healthcare Business, the Director of Healthcare Business serves as an enterprise-level leader responsible for advancing Pacific Clinics’ healthcare business through payer strategy, contracting, and market expansion. This role is primarily accountable for driving revenue growth and diversification by developing and executing payer partnership strategies, leading contract negotiations, and expanding the organization’s presence across multiple healthcare markets. The Director plays a central role in identifying, structuring, and advancing new business opportunities that align with the organization’s long-term strategic objectives. In addition, the Director ensures that payer agreements and new business initiatives are effectively translated into scalable operations by partnering cross-functionally to support implementation, infrastructure alignment, and ongoing performance. Working closely with executive leadership, finance, legal, and operational teams, this position helps position Pacific Clinics for sustained growth, stronger market competitiveness, and long-term success in an increasingly complex payer environment.

Responsibilities:

Payer Strategy & Contracting:

• Oversee full lifecycle of health plan contracting, including negotiation, rate development, and execution in partnership with Finance, Legal and Contract Dept.
• Establish standardized contracting approaches, pricing frameworks, and governance processes
• Maintain alignment between healthcare payer strategy and organizational financial and operational goals

Business Development & Market Expansion:

• Support development and execution of program growth strategies across healthcare payer and partnership opportunities
• Evaluate and prioritize new business opportunities in alignment with organizational strategy
• Partner with executive leadership to advance strategic relationships and expand market presence

Infrastructure, Implementation & Operational Integration:

• Partner cross-functionally with internal departments to support the development of scalable infrastructure and ensure operational readiness for payer contracts and business initiatives
• Collaborate to align workflows, processes, and systems across functions, enabling consistency, compliance, and effective execution
• Support the implementation and ongoing optimization of healthcare business initiatives, ensuring coordination across clinical, operational, and administrative teams

Payer & Executive Relationship Management:

• Develop and maintain strong relationships with payer partners, health systems, and key external stakeholders
• Serve as a primary liaison between Pacific Clinics and payer organizations
• Support executive-level engagement, negotiations, and partnership development
• Ensure long-term partner satisfaction and alignment

Performance & Financial Oversight:

• Partner with Finance and operational leadership to monitor financial performance, revenue realization, and key performance indicators across payer relationships
• Identify risks and opportunities related to payer contracts, including performance trends, reimbursement structures, and evolving value-based expectations
• Support continuous improvement in contract performance, pricing strategies, and operational efficiency, with a focus on outcomes, quality, and long-term value

Organizational Leadership & Collaboration:

• Serve as a key leader across the organization, supporting healthcare business strategy and execution for both new and existing programs.
• Provide guidance and coordination across departments to support healthcare business initiatives
• Represent the organization in internal and external forums
• Perform other duties as assigned to support organizational priorities

Qualifications:

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions.
• Bachelor’s degree in related field and ten (10) years of directly related experience is required; Or equivalent combination of education and experience (two years of relevant experience equals one year of education) to include:
• 5 or more years of experience in business development with demonstrated experience in developing and implementing new health plan business strategies and programs.
• 5 or more years of experience implementing and working with enterprise applications, EHR and other applications required.

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