Director of Provider Network Management

Job Summary

Leading a team in remote operations, the full-time salaried Director of Provider Network Management will manage network operations and contracting activities, focusing on developing provider strategies, negotiating complex contracts, and ensuring a high-performing network aligned with organizational goals.

Key responsibilities

• Develop and implement provider network and contracting strategies to establish a sufficient network of participating providers
• Oversee the preparation and negotiation of provider contracts, ensuring compliance with established templates and guidelines
• Contribute to strategic goals as a key member of the senior leadership team and manage team performance through hiring, training, and development

Required qualifications

• At least 8 years of experience in health care, including provider network management and senior-level network operations experience
• Minimum of 3 years of management or leadership experience
• Extensive experience in the health insurance industry with strong relationships with hospitals and provider groups
• Knowledge of reimbursement methodologies across Medicaid, Medicare, and Marketplace
• Strong negotiation, analytical, and project management skills