Provider Network Manager

Job Summary

To expand employer-sponsored provider networks, the full-time remote Provider Network Manager will build relationships and secure agreements with physician organizations, ambulatory surgery centers, and ancillary providers while managing a portfolio of strategic accounts.

Key responsibilities

• Build and grow provider networks through account plans, relationship cultivation, and contract negotiations
• Negotiate reimbursement and participation terms across various provider specialties and facility types, evaluating fee schedules and modeling expected costs
• Partner with regional leads to prioritize provider gaps and pursue local or multi-market contracts to enhance access

Required qualifications

• Proven experience building and expanding provider networks for payers or provider organizations
• Progressive experience negotiating commercial provider agreements with a record of closing complex contracts
• Broad negotiating experience across various provider specialties and the ability to manage negotiations in multiple markets
• Working knowledge of reimbursement processes, including CPT and HCPCS coding, and the ability to interpret claims data
• Strong communication skills with provider executives and the ability to manage competing priorities effectively