Director, Network Partnerships & Contracting

Added
1 day ago
Type
Full time
Salary
Salary not provided

Related skills

network management healthcare reimbursement value-based care drgs case rates

📋 Description

  • Lead development and execution of provider network partnerships; identify priority markets
  • Own new network launches end-to-end; ensure networks are competitively priced, operationally ready
  • Analyze market intelligence, network economics, reimbursement rates, competitor positioning, and
  • Build and maintain relationships with prospective network partners; translate market insights into
  • Evaluate regional leased-network opportunities and innovative models to support go/no-go and market
  • Negotiate complex healthcare agreements with providers, hospitals, health systems, and vendors

🎯 Requirements

  • Bachelor's degree or equivalent practical experience; 8+ years in provider contracting, network
  • Deep knowledge of provider payment methodologies, including DRGs, case rates, per diems
  • 5+ years in contracting or network roles supporting commercial group markets and employer-sponsored
  • Strong understanding of TPA, ASO, and leased-network arrangements and their implications for
  • 5+ years independently drafting and negotiating complex healthcare agreements with hospitals
  • 4+ years ensuring contracts meet regulatory requirements (federal/state) including No Surprises Act

🎁 Benefits

  • Comprehensive health and wellness benefits designed to support employees and families.
  • Alternative medicine coverage as part of benefits package.
  • Flexible paid time off (PTO).
  • Up to 16 weeks of paid parental leave.
  • Paid holidays.
  • 401(k) program to support long-term financial planning.
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