New Jersey Network Performance Director

Job Summary

A company is looking for a Director, Network Performance.

Key Responsibilities

• Lead the development and execution of the provider network strategy in New Jersey, ensuring network adequacy and coverage
• Oversee provider contracting activities, including new agreements, renegotiations, and compliance with CMS and state regulations
• Drive continuous improvement in workflows, documentation, and provider experience

Required Qualifications

• Bachelor's Degree (strongly preferred)
• 8+ years of provider contracting experience, specifically with hospitals and large groups
• 5+ years of experience leading a network contracting team for a large entity
• Deep knowledge of Medicare Advantage network regulations and reimbursement methodologies
• Proven ability to manage complex negotiations and resolve escalated provider issues