Vice President, Sales (Health Plans) Remote (anywhere in United States)

About the Opportunity:

MacroHealth is transforming how healthcare organizations access, evaluate, and optimize solutions that improve healthcare economics. Through our healthcare marketplace, we connect payers with innovative solutions that help them manage costs, improve performance, and unlock value across multiple categories of healthcare spend.

We're seeking an accomplished Vice President, Sales (Health Plans) to expand our presence among health plans, including Blue Cross Blue Shield organizations. This is a highly specialized, consultative sales role requiring a sophisticated understanding of health plan economics, healthcare cost management, and the operational challenges facing payer organizations.

The ideal candidate brings broad experience identifying and selling healthcare spend optimization opportunities across medical, pharmacy, network, and other cost management categories, with particularly deep expertise in medical claims, payment optimization, and healthcare network economics.

We're looking for someone who can engage credibly with senior payer executives, understand the interconnected drivers of healthcare spend, and develop strategic relationships that create opportunities across our expanding marketplace of solutions.

What You'll Own:

Strategic Market Development & Growth

Develop and execute a targeted new-business strategy focused on regional and provider sponsored health plans including Blue Cross Blue Shield organizations.

Identify and pursue opportunities to optimize healthcare spend across medical claims, provider networks, pharmacy, payment integrity, and other healthcare cost management categories.

Establish trusted relationships with senior leaders responsible for medical economics, healthcare affordability, network management, claims operations, pharmacy, finance, and enterprise strategy.

Develop a comprehensive understanding of each prospect's cost structure, operational environment, existing vendor relationships, and strategic priorities.

Build and advance a high-quality pipeline of complex, high-value enterprise opportunities.

Enterprise Healthcare Spend Optimization

Lead sophisticated conversations with payer executives about the drivers of healthcare spend and opportunities to improve medical and pharmacy cost performance.

Evaluate customer needs holistically, identifying opportunities across multiple spend categories rather than approaching customers through a single product or solution.

Bring deep expertise in medical payment optimization, including out-of-network and out-of-area claims, reimbursement methodologies, payment integrity, and related cost containment strategies.

Demonstrate a strong understanding of healthcare network economics, including network access, provider reimbursement, network optimization, and alternative network solutions.

Understand the broader pharmacy cost management landscape, including PBM economics, specialty pharmacy, and opportunities for improved cost performance.

Translate complex healthcare economics into compelling business cases with measurable financial and operational outcomes.

Position MacroHealth's marketplace model as a differentiated approach to accessing, evaluating, and deploying solutions across multiple categories of healthcare spend.

Complex Enterprise Sales Execution

Own the full sales lifecycle, from market development and strategic prospecting through discovery, solution development, business case creation, negotiation, and contract execution.

Navigate complex payer buying environments involving Medical Economics, Network Management, Pharmacy, Finance, Procurement, Technology, and executive leadership.

Develop multithreaded relationships across customer organizations, building alignment among economic buyers, operational stakeholders, and executive sponsors.

Partner with MacroHealth's Product, Solution Consulting, and Operations teams to develop integrated solutions that address customer priorities.

Structure and negotiate sophisticated commercial arrangements, including performance-based and shared-savings models.

Maintain strong opportunity qualification, pipeline management, and forecasting discipline.

Identify opportunities to expand customer relationships across additional healthcare spend categories as business needs evolve.

Market Intelligence & Strategic Influence

Bring deep knowledge of the regional payer landscape, including market dynamics, competitive offerings, evolving cost management strategies, and emerging customer needs.

Provide insight into the specific operating structures, buying behaviors, and decision-making dynamics of regional and Blue Cross Blue Shield health plans.

Inform MacroHealth's commercial and product strategies through direct customer engagement and market intelligence.

Identify opportunities to expand our marketplace offerings and strengthen our competitive differentiation.

Represent MacroHealth as a credible industry expert and strategic partner to healthcare payer organizations.

What You'll Bring:

Required Qualifications

10+ years of experience in healthcare payer solutions, with a demonstrated track record of success in enterprise sales, strategic business development, or related commercial roles.

Direct sales experience and established executive relationships within Blue Cross Blue Shield plans, particularly regional and independent Blues organizations.

Proven success selling healthcare cost management or spend optimization solutions directly to health plans.

Deep domain expertise in medical claims economics, medical payment optimization, payment integrity, and/or healthcare network optimization.

Broad understanding of healthcare payer economics and the major categories of healthcare spend, including medical, pharmacy, and network-related costs.

Demonstrated ability to identify and develop opportunities across multiple solution categories, rather than selling a narrowly defined product.

Established relationships with regional and independent health plans and experience engaging senior payer executives.

Strong understanding of payer operating models, reimbursement methodologies, provider contracting, and medical cost management practices.

Proven ability to originate, develop, negotiate, and close complex enterprise sales opportunities involving multiple stakeholders and extended buying cycles.

Exceptional consultative selling capabilities, including the ability to analyze customer economics, quantify opportunities, and build compelling financial business cases.

Strong commercial judgment, executive presence, and ability to operate independently in a dynamic, growth-oriented organization.

Highly Preferred Qualifications

Direct sales experience and established executive relationships within Blue Cross Blue Shield plans, particularly regional and independent Blues organizations.

Experience selling medical payment integrity, out-of-network or out-of-area claims optimization, repricing, or medical cost containment solutions.

Experience selling network optimization, alternative network solutions, provider reimbursement optimization, or related offerings.

Familiarity with the BlueCard ecosystem and the unique operating dynamics of Blue Cross Blue Shield organizations.

Experience selling or developing opportunities across multiple healthcare spend categories, including pharmacy cost management.

Experience structuring performance-based, shared-savings, or other value-oriented commercial arrangements.

Background with a healthcare cost management, payment integrity, network solutions, or payer-focused healthcare technology organization.

Why MacroHealth:

MacroHealth offers a differentiated opportunity to help healthcare payers rethink how they optimize spend and access innovative solutions. Rather than representing a single point solution, you'll bring customers access to a broader marketplace of healthcare cost optimization capabilities, helping them address multiple financial and operational challenges through a strategic partnership. You'll have the opportunity to shape our regional payer market presence, develop meaningful executive relationships, and contribute directly to the next stage of MacroHealth's growth.

Compensation:

The expected on target earnings for this role is $350,000-$400,000 annually. This range reflects the good-faith minimum and maximum MacroHealth reasonably expects to pay for this role at the time of posting. Actual pay within this range depends on relevant experience, skills, qualifications, and, where permitted, geographic location. This role is eligible for a comprehensive benefits package,