The Director of Payer Strategy & Network Development plays a pivotal role in expanding the adoption of NCQA programs within health plan network development and provider contracting strategies, including alignment with value-based care initiatives.
This role builds relationships with health plan executives responsible for network strategy, provider contracting, and quality initiatives to support how they integrate NCQA programs into network design, reimbursement models, and provider incentives. The ideal candidate understands how health plans build networks, contract with providers, and structure reimbursement and quality incentives. They will collaborate with NCQA’s sales, policy, and product teams to align NCQA’s offerings with payer needs and drive adoption. By expanding the use of NCQA programs, this role helps drive better health outcomes, improve accountability, and build trust in healthcare networks—ensuring patients receive high-quality care from organizations committed to excellence. Responsibilities:
- Account Engagement – Build and maintain relationships with C-suite and VP-level executives at health plans, focusing on network development, provider contracting, and quality strategy teams.
- Drive Adoption – Secure NCQA program adoption within major health plans’ quality, network, and reimbursement strategies, positioning NCQA as a key component of value-based care initiatives.
- Develop Quality & Business Case for NCQA Programs – Create data-driven, compelling business cases demonstrating the ROI of NCQA programs in improving outcomes, strengthening provider networks, and advancing value-based care.
- Education & Advocacy – Educate and influence payers on how NCQA programs enhance value-based care, provider accountability, and quality-based payment models, ensuring alignment with their strategic objectives.
- Explore Market Expansion Opportunities – Partner with employers, benefit leaders, and industry stakeholders to promote quality-driven network selection and expand NCQA’s influence beyond traditional payer relationships.
- Market Intelligence – Stay ahead of payer contracting strategies, regulatory trends, and provider network policies, leveraging insights to inform NCQA’s product positioning, sales strategy, and market approach.
- Business Management & Intelligence – Own and manage the sales pipeline, forecasting, and performance tracking in Salesforce, ensuring alignment with quarterly and annual revenue targets.
- Other duties as assigned.
Requirements
- 7+ years of experience selling enterprise healthcare solutions to health plans, with a focus on network development, provider contracting, or quality improvement
- Deep understanding of provider network operations, value-based contracting, and payer-provider relationships
- Proven track record managing complex healthcare sales cycles
- Bachelor’s degree in business, healthcare administration, or a related field; Master’s degree preferred
Essential Skills
- Strategic account planning and execution
- C-suite level presentation, negotiation, and relationship management
- Healthcare quality metrics and outcomes analysis
- Proficiency in Salesforce for pipeline management, forecasting, and reporting
- Cross-functional project leadership
Preferred Skills
- Familiarity with NCQA programs and their role in payer strategies.
- Knowledge of employer-sponsored healthcare and benefit design.
- Demonstrated success in influencing payer policies.
- Proficiency in healthcare data analysis to support business case development.
Working Conditions
- Remote work with 25% travel to client sites
- Position eligible for performance-based compensation
Compensation & Benefits:
- For new hires, this position pays in the range of $145K - $180K per year, depending on experience.
- This position is eligible for an annual incentive bonus, payable in accordance with policy.
- Click here for employee benefit information.
NCQA is committed to being an employer of choice and fostering an inclusive culture and workplace.We are an Equal Opportunity Employer/Protected Veterans/Individuals with DisabilitiesNCQA is a drug free workplace. NCQA recruits, hires, trains and promotes individuals, and administers any and all personnel actions, without regard to race, color, religion, national origin, age, sex, pregnancy, citizenship, familial status, disability status, veteran status, genetic information, or other protected statuses under applicable state and federal laws.NCQA will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.
41 CFR 60-1.35(c).
