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RISA · 13 hours ago

Payer Partnerships Lead

Washington, DC

Full-time

Hybrid

Senior Level

6+ years exp

RISA is hiring a Payer Partnerships Lead to build and scale payer relationships for RISA’s Unified Payer Interface. This role involves managing end-to-end payer partnerships, driving strategic conversations, and navigating compliance requirements to operationalize federal mandates.

Artificial Intelligence (AI)Enterprise Software

Responsibilities

Own payer partnerships end-to-end, from cold outreach and relationship development through contracting, technical integration, launch, and long-term expansion

Proactively identify and engage target payer organizations (Commercial, Medicare Advantage, Medicaid managed care) and drive strategic conversations across Product, Interoperability, Engineering, Operations, Legal, Compliance, and Security stakeholders

Lead payer discussions on interoperability and data exchange, including FHIR, X12, HL7 APIs, and CMS Da Vinci implementation guides (PDex, CRD, DTR, PAS)

Act as a trusted partner to payers navigating CMS interoperability and prior authorization mandates, including CMS-0057-F, translating regulatory requirements into executable technical and operational solutions

Navigate payer security reviews, compliance requirements, and contracting processes with minimal process and high ambiguity

Clearly articulate RISA UPI’s technical differentiation and business value, translating complex infrastructure and interoperability concepts into outcomes that resonate with payer executives

Build the payer partnership playbook from the ground up, including ICP(ideal customer profile) definition, outreach strategy, partnership and integration models, onboarding approaches, and success metrics

Represent RISA at industry events, payer forums, and strategic meetings, building credibility, thought leadership, and pipeline

Identify expansion opportunities within existing payer accounts and feed real-world payer insights back into product and GTM strategy

Qualification

Healthcare payer experienceHealthcare interoperability standardsCMS interoperability mandatesPartnershipsBusiness developmentTechnical integrationCommunication skillsRelationship buildingStrategic thinking

Required

6–10+ years of experience working with or selling into healthcare payers, ideally in partnerships, business development, product, interoperability, or enterprise SaaS roles

Strong working knowledge of healthcare interoperability standards, including FHIR, X12 (270/271, 276/277, 837, 835), APIs, and HL7

Hands-on familiarity with CMS Da Vinci implementation guides (PDex, CRD, DTR, PAS) and payer implementation realities

Deep understanding of CMS interoperability mandates, including CMS-0057-F, and how policy translates into payer operational and technical requirements

Proven ability to initiate partnerships from zero—cold starts, long sales cycles, and multi-stakeholder environments

Ability to translate deeply technical interoperability and infrastructure concepts into clear business value and ROI narratives for payer leadership

Willingness to travel approximately 30–50%