Payer Lead, Medicaid

Babylist

6d•Remote

About The Position

The Payer Lead – Medicaid will own Babylist Health's end-to-end Medicaid contracting strategy and execution. This role is responsible for unlocking one of the company's largest growth opportunities by securing state Medicaid licenses and Managed Care Organization (MCO) contracts, expanding Babylist Health's footprint across high-birth-volume states, and building durable payer relationships that enable long-term scale. This person will set the Medicaid market strategy in partnership with the GM, and be responsible for execution of this strategy end to end. Their scope will include prioritizing state license applications, driving direct contracting efforts, and building the external relationships (trade associations, payer stakeholders, regulators) required to win in competitive Medicaid markets.

Requirements

6–8+ years of experience in payer contracting, with deep Medicaid and MCO expertise
Prior experience at a DME, healthcare services company, or payer-adjacent organization
Proven track record of securing state licenses and MCO contracts
Strong existing relationships across Medicaid agencies, MCOs, and industry trade groups
Comfort operating in complex regulatory environments
Able to get hands-on and in the weeds to deliver iron clad contracts that can be turned on expeditiously
You're comfortable and enthusiastic about working in an AI-forward environment where AI tools are part of daily operations
You embrace using technology to enhance your work while keeping people at the center

Nice To Haves

Experience at a health-tech, high growth, or similar start up environment a plus

Responsibilities

Medicaid Coverage Growth
Own the Medicaid expansion roadmap, including state prioritization, sequencing of license acquisition, and MCO penetration targets.
Partnering with an outside consulting firm to submit Medicaid license applications in prioritized states Execute a strategy to access up to 40% of U.S. births covered by Medicaid, with a focus on populous states (e.g., CA, TX, NY)
Partner with the GM, Finance and leadership to model revenue impact, timing, and ROI of Medicaid expansion initiatives
State Licensing & Regulatory Navigation
Partner with our consultants to submit state Medicaid DME license applications, ensuring timely, compliant, and scalable submissions
Anticipate and navigate state-specific regulatory complexity, red tape, and documentation requirements
Serve as the senior point of contact for Medicaid agencies, regulators, and licensing bodies
MCO Contracting & Relationship Development
Lead direct MCO contracting efforts, including outreach, negotiations, and ongoing relationship management
Build a pipeline of warm leads through trade associations, industry events, and payer networks to accelerate contract wins
Negotiate favorable contract terms that balance access, operational feasibility, and long-term margin potential
Cross-Functional Collaboration
Establish scalable Medicaid contracting processes, playbooks, and best practices
Partner closely with Operations, Billing, Legal, and Product to ensure Medicaid contracts are operationally live, compliant, and customer-ready
Ensure Medicaid expansion does not negatively impact denial rates, AR, or patient experience
Success Metrics
Number of new state Medicaid licenses secured
Number and breadth of MCO contracts executed
Percentage of Medicaid population accessible
Time from license approval to MCO contract activation
Revenue contribution from Medicaid contracts

Benefits

Competitive salary with equity and bonus opportunities
Company-paid medical, dental, and vision insurance
Retirement savings plan with company matching and flexible spending accounts
Generous paid parental leave and PTO
Remote work stipend to set up your office
Perks for physical, mental, and emotional health, parenting, childcare, and financial planning

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