Healthcare Growth & Payer Strategy

The clinician who
speaks payer.

Twenty years across the full healthcare value chain: treating patients, owning a practice, running clinics, reviewing utilization, and leading enterprise health plan partnerships at the vice-president level. I translate clinical, operational, and financial complexity into decisions executives can act on.

Justin Clifford
20+ Years in healthcare, clinical through executive
100% Account retention across every health plan relationship owned
$15M+ Same-store growth across strategic payer accounts
23/30 State Medicaid plans supported on a single national account
What makes the difference

I've sat in every seat in the room.

I've treated patients, carried a revenue number, and negotiated contracts, building a working fluency in both clinical care and commercial strategy. That combination is what lets me build solutions that actually hold up for the patient, the provider, the payer, and the business at the same time.

Clinician

Delivered direct patient care for roughly sixteen years. I know what documentation burden and prior-authorization friction feel like from the treatment room.

Practice owner

Founded a physical therapy clinic, grew it to about twenty employees, and sold it profitably. Payer contracting, revenue cycle, staffing, and margin were mine to solve.

Multi-site operator

Directed outpatient clinics and regional operations: budgets, hiring, productivity, clinical quality, and financial performance across locations.

Clinical reviewer

Worked inside utilization management and clinical policy, which is where most payer–provider friction is actually created or resolved.

Provider relations

Led the work of reducing provider abrasion and untangling network, claims, and reimbursement issues on behalf of health plans and their networks.

Enterprise executive

Owned vice-president-level relationships with health plan presidents, CMOs, CFOs, COOs, and network and procurement leaders across Commercial, Medicare Advantage, Medicaid, and ASO.

Track record

Where I've done the work.

eviCore Healthcare / Evernorth Oct 2024 – Apr 2026

VP, Client Relationship Executive | $4.5M Quota, 100% Retention | Payer Growth & Relationship Recovery

eviCore by Evernorth is the largest prior authorization company in the U.S., supporting over 100 million patients annually across 100+ health plan partners.

  • Owned 7 national and regional health plan clients, including the company's second-largest revenue account, achieving 100% account retention through direct relationship management and contract negotiation.
  • Sold and supported a full suite of medical benefit management (MBM) solutions across Commercial, Medicare Advantage, Medicaid, and ASO markets, including imaging, cardiology, musculoskeletal care, oncology, sleep studies, payment integrity, gastroenterology, lab management, and genetics.
  • Carried an individual annual growth quota of $4.5 million within a formal enterprise growth team, on a base, commission, and bonus structure, with approximately 60% of total compensation performance-based.
  • Improved relationship trust, client satisfaction, and NPS at 5 of 7 accounts within the first year, directly contributing to $2 million in closed business and an additional $10 million in qualified pipeline within 15 months on a newly inherited, previously strained portfolio.
  • Led quarterly business reviews and executive governance cadences, building consensus among stakeholders with competing priorities.
Evolent Health Jan 2022 – Oct 2024

Senior Director, Strategic Growth | $15M+ Growth Year | 23-State Medicaid & Medicare Account

Evolent Health (NYSE: EVH) is a publicly traded company with over $2.5B in annual revenue, managing specialty care for tens of millions of lives nationally.

  • Led 9+ Account Managers to successfully support a national Medicaid and Medicare managed-care payer account spanning 23 of 30 regional health plans, achieving 100% account retention.
  • Sustained that relationship continuously for 6 years through a company acquisition and leadership transitions, preserving trust and performance through significant organizational change.
  • Demonstrated $15M+ in growth while absorbing the responsibilities of a departing leader and operating at expanded, VP-level scope.
  • Built multi-year account strategies connecting payer priorities to clinical, utilization, financial, quality, and member-experience outcomes while aligning senior stakeholders on value, timing, and execution.
  • Translated performance, benchmark, savings, and implementation data into executive business reviews, corrective action plans, renewal strategies, and growth narratives.
Magellan Health / National Imaging Associates Jul 2018 – Dec 2021

Director of Account Management | 13+ Health Plan Partnerships | Provider Relations to Account Leadership

Magellan Health was a Fortune 500 company (#390, 2021) with approximately $4.6B in annual revenue and 9,000+ employees, later acquired by Centene in 2022.

  • Advanced through four progressively senior roles, from Senior Provider Relations Manager to Director of Account Management, building deep fluency in provider engagement, utilization management, and health plan operations.
  • Directed 6+ Account Managers to consistently strong performance across 13+ distinct Medicaid- and Medicare-focused partnerships, with direct responsibility for coaching and development.
  • Strengthened performance and stakeholder confidence by diagnosing provider-workflow issues directly at provider offices and delivering practical, data-driven solutions.
  • Recognized as Most Valuable Account Executive, 2021, for consistently exceeding performance expectations.
Provider & clinical leadership 2003 – 2018

Practice Owner, Group Director, Director of Physical Therapy

  • Advanced from staff physical therapist to group director within five years, growing to oversee five outpatient clinics across the Phoenix metro area.
  • Co-founded and grew an independent outpatient physical therapy practice to two locations and roughly twenty employees, owning business development, payer contracting, financial performance, staffing, and operations, before a profitable sale.
  • Returned to group director roles overseeing two to four outpatient clinics, including through a corporate acquisition, with continued budget, hiring, quality, and growth accountability.
Capabilities

What I'm brought in to solve.

Relationship recovery

Turning strained, at-risk partnerships into stable and expanding ones, usually by fixing governance and accountability before touching the commercials.

Payer strategy & economics

Cost-of-care analysis, risk-based and delegated arrangements, capitated pricing, and performance commitments across all lines of business.

Enterprise account ownership

Retention, renewals, contracting, and expansion on complex multi-stakeholder accounts where the buying committee spans clinical, financial, and operational leadership.

Executive translation

Turning utilization data, clinical outcomes, and operational performance into a narrative an executive team can make a decision from.

Cross-functional execution

Quarterbacking clinical, product, analytics, implementation, operations, finance, legal, and contracting teams toward a client commitment.

Workflow transformation

Reducing provider abrasion and administrative burden in specialty utilization management and medical benefit management.

From the blog

The clinician who speaks payer, nine stories so far.

Where the instinct came from, the frameworks I keep coming back to for rebuilding trust in relationships everyone else had already written off, and the occasional lesson from the volleyball court. Meant to be read in order. The series adds a new story every week.

What's next

Where I'm looking to land.

Organizations that value healthcare depth in strategic account leadership, where owning complex payer and provider relationships, and being credible with both clinicians and CFOs, is the point of the role.

The work I do best

  • Consultative, durable growth
  • Executive client ownership
  • Complex payer and provider relationships
  • Navigating complex, multi-stakeholder sales cycles

Location & model

Based in the Lake Norman area of North Carolina, near Charlotte. Strong preference for remote work, and open to travel where the opportunity warrants it.

Credentials

Education.

Doctor of Physical Therapy

A.T. Still University of Health Sciences

B.S., Exercise Science

Montana State University
Contact

Let's talk.

If you're building a team where clinical credibility and commercial discipline have to coexist, I'd welcome the conversation.