Business Development and Government Relations Director

Business Development and Government Relations Director

Reports To: CEO

FLSA Status: Full Time; Exempt

Pay Range: $130,000.00- $160,000

Position Summary:

The Business Development and Government Relations Director is responsible for developing and supporting the full cycle of sales and contracting activities for ACO network expansion, federal and state agency contracts, grants and direct customer agreements. This role will be responsible for managing and cultivating strategic relationships with state agencies, monitoring and interpreting policy developments, and advocating for policies that positively impact Carina Health Network's lines of business. This role requires proactive engagement with policymakers, regulatory authorities, and industry stakeholders to support favorable legislative outcomes. The Business Development and Government Relations Director identifies and develops new business relationships and serves as a liaison between customers and internal staff to ensure timely and successful onboarding of clients from sales into operations.

This position is responsible for researching and writing proposals to foundations, government agencies, and other grant-making organizations, through persuasive communication about our mission, VBC contracts, services and programs. This position will maintain close relationships with partner agencies and stay current on the priorities of all relevant funding opportunities locally and nationally while vigorously pursuing opportunities on an ongoing basis. The Business Development and Government Relations Director will strategically expand Carina Health Network's value-based care provider network, emphasizing growth in Medicaid, Medicare and commercial sectors. This role involves designing innovative Medicaid value-based care contracts, building relationships with community health centers, Regional Accountable Entities (RAEs) and the Colorado Department of Healthcare Policy and Finance (HCPF).

This position will also establish groundbreaking technology, service, and population health agreements with state agencies and community organizations. The ideal candidate will demonstrate extensive knowledge in the business of healthcare, proven leadership in business development, strong relationships and a strategic mindset. Creativity and innovation are an expectation of this role.

Duties/Responsibilities:

ACO Business Development and Expansion

• Identify, evaluate, and pursue new growth opportunities within the value-based care landscape
• Develop and execute strategic plans to expand the value-based care provider network within Medicaid, Medicare and commercial markets.
• Lead negotiations and relationship-building activities to expand the ACO network, bringing new providers and organizations into strategic partnerships
• Develop and manage a robust pipeline of partnership opportunities and continuously monitor market trends

Medicaid Value-Based Care Contract Development

• Identify opportunities to expand the network to support the Medicaid population by coordinating with the Community Health Centers, the Regional Accountable Entities (RAEs) and other Medicaid providers and community-based organizations
• Support the Value-Based Care Division in the design of a Medicaid shared savings model
• Manage the development, implementation, and refinement of innovative Medicaid value-based care initiatives aimed at improving quality, patient outcomes, and cost efficiency.
• Collaborate with internal clinical, financial, and operational stakeholders to develop viable models and financial incentives aligned with Medicaid value-based goals.
• Maintain current knowledge of regulatory, legislative, and policy changes impacting Medicaid and adapt strategies accordingly.

Government Relations

• Manage and nurture effective relationships with key state agencies, policymakers, regulatory authorities, and other governmental stakeholders.
• Proactively monitor, analyze, and interpret legislative and regulatory developments impacting Carina Health Network’s business areas, including healthcare policy, Medicaid, Medicare, and commercial healthcare markets.
• Develop and execute strategic advocacy plans in coordination with our sister organization, the Colorado Community Health Network (CCHN), aimed at influencing state policy decisions that align with the organization's mission and strategic objectives.
• Represent Carina Health Network in policy discussions, regulatory hearings, and industry forums to articulate organizational positions and recommendations.
• Coordinate with internal business units to assess the impacts of proposed legislation and regulation, advising senior leadership on strategic responses.
• Collaborate closely with industry associations, coalitions, and external partners to amplify advocacy efforts and policy influence.
• Prepare comprehensive briefings, legislative reports, position statements, and presentations for internal and external stakeholders.
• Provide expert policy guidance to ensure compliance with regulatory changes and to optimize business operations under evolving legislative environments.
• Analyze market trends, competitive landscape, and regulatory developments to inform strategic growth initiatives.

Technology and Services Contracting

• Identify and pursue opportunities for strategic partnerships with state and local health agencies, primary care, behavioral health and community-based organizations to introduce new technology solutions, services, and population health management contracts.
• Stay current with emerging healthcare technology trends, digital innovations, and advancements in population health technology

Evaluation of Programs and Initiatives

• Evaluate the effectiveness and viability of new and existing value-based programs and partnerships, providing recommendations for optimization or expansion.
• Conduct market research, data analytics, and financial analysis to support evidence-based decisions for program development and partnership selection.

Required Knowledge, Skills, and Abilities:

• Collaborate cross-functionally with clinical, operational, legal, and technology teams to ensure alignment in contract development and execution.
• Prepare and present strategic recommendations, proposals, and updates to senior leadership and board members.
• Meet and exceed growth targets, maintaining accountability for strategic revenue and network expansion goals.
• Works closely with the Executive Team to identify annual business development goals and sales quotas
• Develop and maintain a working knowledge of all of Carina Health Network’s products and services; VBC contracts, health information technology and analytics
• Maintain working knowledge of the healthcare landscape in the state of Colorado and nationally
• Research and identify sales and funding opportunities via networking and discovery interviews with stakeholders
• Develop proposals and manage the sales pipeline through contract signing and onboarding
• Assist with the development of processes, policies, and procedures for business development activities
• Eventually managing staff within the Business Development team and developing clear goals, objectives, and growth plans for each individual
• Manage the customer development interview process to help product teams understand and develop solutions that meet the needs of the customer
• Strategize existing and potential new clients on Carina Health Network’s products and services
• Work with the Executive Team, project leaders, and project managers to identify additional sales needs and opportunities
• Identify traditional and innovative methods for receiving financial support for Carina Health Network programs
• Manage the development of high-quality grant proposal narratives, applications, letters, budgets, and other supporting documents
• Manage the process for responding to requests for proposals (RFP)
• Maintain a customer relationship management (CRM) tool and other documentation to track leads and sales progress
• Generate regular status reports for executives and program leadership

Education:

• Bachelor's degree required;
• Master's degree in Business Administration, Healthcare Administration, Public Health, or related field preferred.

Qualifications and Experience:

• Minimum 7-10 years of experience in healthcare business development, contract negotiation, and/or provider network management
• Proven experience with Medicare, commercial, and/or Medicaid value-based care contracts.
• Demonstrated success in establishing partnerships with state/local health agencies.
• Strong understanding of healthcare technology and population health strategies.
• Exceptional communication, negotiation, and interpersonal skills.
• Strategic thinker with the ability to manage multiple priorities and drive initiatives from conception to implementation.

Working Environment/Physical Requirements:

• Hybrid position - work from home with 25% travel capability
• Position may require several hours of travel to meetings in the state of Colorado
• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift 15 pounds at times.
• Must be able to access and navigate each department at the organization’s facilities.
• Must have a valid driver’s license

We are an equal opportunity employer offering a casual work environment, and a competitive salary (DOE), and the following generous benefits package:

• Insured group health, dental, & vison plans (NOTE: Medical Insurance may not be available for out of state employees)
• Medical and dependent care flexible spending account options
• 401k retirement plan with an employer contribution match
• Life, AD&D, and Long-term disability plans paid for by employer
• Free 24/7 access to confidential resources through an Employee Assistance Program (EAP)
• Voluntary benefit plans to complement health care coverage including accident insurance, critical illness, and short-term disability
• A generous mix of vacations, sick and paid days off for company’s 12 recognized holidays