Director of Payer Contracting

Job description

### About us Pomelo Care is the leading virtual medical practice for women and children, providing care across pregnancy, postpartum, pediatrics, menopause, and perimenopause. We combine proactive, 24/7 clinical care with technology that helps us reach patients earlier, identify risks sooner, and deliver personalized care throughout their journey. Our team includes clinicians, technologists, operators, and problem-solvers working together to make high-quality care more accessible for families nationwide. ### **About The Role:** We are looking for a Director of Payer Contracting to drive market expansion for our Midlife line of business. In this role, you will define our health plan engagement strategy and lead end-to-end contracting from sourcing through signature. Partnering closely with senior payer executives and internal teams, you will leverage deep commercial payer expertise to structure high-impact deals that expand access, optimize margins, and accelerate enterprise growth. This role reports to the EVP of Commercial Partnerships and can be located anywhere in the continental US. ### **What you'll do:** - Define payer contracting strategy, including approach to engagement, (re)negotiation & expansion - Refine & share Pomelo's value proposition with commercial health plans, grounded in cost savings, access, and/ outcomes associated with the (peri)menopause episode of care - Lead payer contract negotiations directly with health plans from sourcing through signature, structuring deals that balance growth, margin, and long-term partnership - Build and maintain trusted, senior-level relationships with payer executives who can champion Pomelo internally - Track the regulatory, competitive, and reimbursement landscape to keep strategy current - Partner closely with Operations, Finance & Legal teams to pressure-test deal economics and ensure smooth handoffs before & after deals are signer ### **Who you are:** - 8+ years of experience in payer contracting, payer partnerships, network strategy, and/or business development, with a track record of negotiating and closing contracts directly with health plans. - Strategic thinker who can move fluidly between big-picture market strategy and the granular term sheet details. - Skilled, confident negotiator who has led complex commercial negotiations with senior payer stakeholders - Deep familiarity with payer economics, reimbursement models, and the commercial health plan landscape - Excellent written and verbal communication skills, with the ability to build a compelling, data-backed narrative and deliver it persuasively to executive audiences. - Comfortable operating with significant ambiguity in a fast-paced, high-growth startup environment, and able to build a strategy and process from scratch. - Experience in virtual care / digital health **Why you should join our team** By joining Pomelo, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup that always puts the patient first. You will learn, grow and be challenged, and have fun with your team while doing it. We strive to create an environment where employees from all backgrounds are respected. We value working across disciplines, moving fast, data-driven decision making, learning, and always putting the patient first. **Benefits and Perks:** - Comprehensive Health, Dental, and Vision coverage for employees and their families - High deductible Health Plans with Health Savings Account (HSA) options - Flexible Spending Account (FSA) - Equity grant participation - 401(k) program - Competitive vacation policy - 16 weeks paid parental leave - Fully remote work flexibility (within the US) **Compensation:** The expected base salary range for this role is $180,000-$200,000. This role is also eligible for variable compensation, with expected on-target earnings of $240,000-$266,000, and equity, giving you an ownership stake in Pomelo’s mission. Actual compensation may vary based on relevant experience, skills, competencies, and certifications. At Pomelo, we are committed to hiring the best team to improve outcomes for all mothers and babies, regardless of their background. We need diverse perspectives to reflect the diversity of problems we face and the population we serve. We look to hire people from a variety of backgrounds, including but not limited to race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status. ### **Potential Fraud Warning** *Please be cautious of potential recruitment fraud. With the increase of remote work and digital hiring, phishing and job scams are on the rise with malicious actors impersonating real employees and sending fake job offers in an effort to collect personal or financial information.* *Pomelo Care will never ask you to pay a fee or download software as part of the interview process with our company. Pomelo Care will also never ask for your personal banking or other financial information until after you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All official communication with Pomelo Care People Operations team will come from domain email addresses ending in @pomelocare.com.* *If you receive a message that seems suspicious, we encourage you to pause communication and contact us directly at [careers@pomelocare.com](mailto:careers@pomelocare.com) to confirm its legitimacy. For your safety, we also recommend applying only through our official [Careers](https://www.pomelocare.com/careers) page. If you believe you have been the victim of a scam or identity theft, please contact your local law enforcement agency or another trusted authority for guidance.*