Fractional Business Development Leader

Fractional Business Development Lead- Medicaid Managed Care

Remote (US-based)

About Nest Health

Nest Health, launched in New Orleans, LA, is Nest Health is a new, whole family healthcare practice delivering convenient and compassionate house calls and virtual care to parents and their kids. Nest makes healthcare easy for moms, dads, babies, kids and teens living in the same home. With evening and weekend appointments, house calls, virtual visits, same day and next day availability, plus a 24/7 nurse line, families do not need multiple appointments, extra time off work, childcare or transportation to get the help and care they need, when they need it.

We are guided by our CHARJ, the Nest core values:

• Collaboration – We collaborate with each other, with families and with the communities we serve
• Humility – We recognize that our teammates and our member families often have the answers
• Authenticity – We bring our diverse experiences and real selves to our work
• Resourcefulness – We are builders and problem solvers
• Joy – We bring joy to our work and our member families

Nest was co-founded by Dr. Rebekah Gee, the former Secretary of Health for the State of Louisiana and the former CMO for Medicaid and the Title V program; and Rebecca Kavoussi, former Western US President at Landmark Health and former head of global clinical operations at Babylon Health. Employees will be afforded an opportunity to develop and drive their careers with this fast paced and innovative company while receiving competitive compensation, paid holidays, vacation, excellent medical health, vision and dental coverage; short term and long-term disability coverage; and the ability to contribute to a 401K.

Role Summary

Nest Health is seeking a highly experienced Fractional Business Development Lead with specialized knowledge in Medicaid market trends, Medicaid payers and providers, and negotiating value-based contracts with and within manager care organized (MCOs). You will refine and manage Nest’s state expansion strategy plan, leverage your own and Nest’s MCO contacts, drive partnership discussions and timelines, and negotiate mutually successful Nest’s next state contract(s). Work under an incentive model to ensure timely closure of deals and agreements.

What You’ll Do

• Market Analysis and Opportunity Identification: Refine and enhance Nest’s market analysis, conducting research on potential states, target markets, competition, and payers to build and prioritize growth opportunities.
• Strategic Partnership Development: Leverage your own and Nest’s relationships to secure introductory relationships and cultivate strategic partnerships with managed care organizations (MCOs). Identify local consulting resources as needed.
• Pipeline Management: Ensure comprehensive understanding and effective capture of pertinent information for business development efforts, including, stakeholders and decision-makers, payer priorities, and regulatory details, as well as deal stage and deal probability.
• Contract Negotiation: Understand payer priorities and existing contract vehicles to streamline and expedite negotiations. Lead contract negotiations with payers to secure favorable terms and agreements that align with Nest Health’s strategic objectives.
• Cross-functional Collaboration: Collaborate closely with internal Legal, Finance, Actuarial, and Operations teams.

Experience, Qualifications & Skills

• Proven Experience: Minimum of 5 years of progressive experience in business development, with a background negotiating Medicaid contracts from the health system and/or payer side. Dual experience on the provider side highly preferred.
• Industry Knowledge: Deep understanding of Medicaid policies, regulations, and reimbursement models, and familiarity with managed care organizations.
• Value-based Care: Must have experience with value-based care models and contracts.
• Contract Negotiation Skills: Demonstrated success in negotiating complex contracts within the healthcare sector, including Medicaid and managed care organizations.
• Strategic Thinker: Strong strategic and analytical skills with the ability to assess market trends, identify growth opportunities, and develop effective business strategies.
• Communication Skills: Excellent interpersonal, communication, and presentation skills. Ability to articulate complex concepts and negotiate effectively with diverse stakeholders.
• Results-Driven: Proven track record of achieving business development targets and driving revenue growth in a competitive healthcare environment under a deadline driven incentive model.
• Education: Bachelor’s degree in Business Administration, Healthcare Administration, or a related field. Advanced degree (MBA, MHA) preferred but not required.

Nest Health celebrates the diversity of our patient population and seeks diversity on our team. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.