Omada Health is on a mission to inspire and engage people in lifelong health, one step at a time.
We are seeking a seasoned health plan strategist who relishes the challenges of leading payer access strategies and execution for digital health provider solutions. As the Director of Payer Strategy and Planning, you will work with the VP of Payer Access, other leaders on the Payer Access team, and cross functional teams including but not limited to marketing, sales, clinical, engineering, and product development. A successful candidate will be expected to source data and information, collaborate with internal and external stakeholders, develop compelling strategic narratives, simplify strategic direction into actionable plans that generate outsized growth in the number of health plan/PBM/third party covered lives that cover and reimburse Omada programs.
The Director of Payer Strategy and Planning will report to the Vice President of Payer Access and will be a standing member of the Payer Access Lead Team. The ideal candidate will possess knowledge and experience both in health plans/PBMs and digital health. S/he will know what key payer decision-makers care about when evaluating digital health offerings such that the s/he will be able to translate these insights into strategy and execution plans.
Payer Strategy (30%)
- Translate Company vision, mission, strategy and objectives into Payer Access (PA) vision, strategy and objectives
- Support & develop PA Account Targeting Strategy and go-to-market (GTM) strategy; identify accounts by segment
- Develop payer value story and partner with marketing to develop payer buyer journey
- Develop clinical data, outcomes, and ROI strategy
- Serve as the voice of payer to internal teams (Product, Pricing, Eng., Care Delivery, etc.)
- Create and update environmental scan of payer marketplace, needs and competitor activity
- Partner with payer access leaders and commercial enablement to develop capabilities development plans aligned to vision, strategy, and objectives
- Special projects commissioned by VP of Payer Access / Commercial lead team, including but not limited to business development due diligence
Planning and Execution (50%)
- Lead Payer Access team governance and business planning
- Partner with marketing and commercial operations to develop product and segment specific value proposition and asset/tools/ROI/economic business case
- Partner with HPAEs and SAMs to develop account specific strategy and tactics for major accounts
- Establish Pipe process and goals and metrics
- Partner with Commercial Operations and Enablement to develop GTM playbooks
Contracting and Pricing (20%)
- Collect & analyze market insights and partner with VP National Accounts to support deal strategy for National Accounts
- Build, support, and evaluate processes for managing non-standard deal requests (Product, Pricing, Engineering, Care Delivery, etc.)
- Partners with Legal and National Accounts to translate deal terms into contract paper
- Background in large health plans and has developed strategy
- Adept at building and telling compelling strategic narratives
- Has in-depth health plan and PBM experience
- Understands how payers and PBMs make decisions regarding digital health, medical services and/or pharmaceutical services or formularies.
- Solid understanding of the contract process, deal structures, and contract negotiation.
- Excellent project management, organization, and communication skills.
- Comfortable working with the ambiguity of a fast-paced startup - ability to innovate, and solve problems creatively
- Strong presentation and group facilitation skills
- An agile, intelligent, dynamic thinker with ability to tailor messages and communications to the intended audience and respond nimbly during prospect meetings across numerous topics
- Travels up to 25% of the time (if remote, travel needed periodically to San Francisco HQ)
- Competitive salary
- Stock options (extended post termination option exercise window for Omadans who are with us 3 years or more)
- Flexible vacation to help you rest, recharge, and connect with loved ones
- Generous parental leave
- Health, dental, and vision insurance (and above market employer contributions)
- 401k retirement savings plan
- Two giftable Omada enrollments per calendar year
- ...and more!
About Omada Health: Omada Health is a digital care provider that empowers people to achieve their health goals through sustainable behavioral change. Working with health plans, employers, and health systems, the company delivers personalized interventions for individuals dealing with chronic conditions, musculoskeletal issues, anxiety, and depression. Combining data-powered human coaching, connected devices, and curriculums tailored to an individual’s specific conditions and circumstances, Omada has enrolled more than 400,000 participants across all 50 states. Omada’s partners include major employers across the country, including Costco and Iron Mountain, as well as leading health plans, such as Cigna and Kaiser.
We carefully hire the best talent we can find, which means actively seeking diversity of beliefs, backgrounds, education, and ways of thinking. We strive to build an inclusive culture where differences are celebrated and leveraged to inform better design and business decisions. Omada is proud to be an equal opportunity workplace and affirmative action employer. We are committed to equal opportunity regardless of race, color, religion, sex, gender identity, national origin, ancestry, citizenship, age, physical or mental disability, legally protected medical condition, family care status, military or veteran status, marital status, domestic partner status, sexual orientation, or any other basis protected by local, state, or federal laws.