Position Purpose
This position is responsible for leading provider contracting, network development, and related strategic initiatives to support organizational goals for access, quality, affordability, and regulatory compliance. The incumbent provides leadership in the development, negotiation, interpretation, and administration of complex provider agreements and associated documents, and works collaboratively with legal counsel and operational leaders to ensure contract language, rate strategies, and network design align with business, regulatory, and market requirements. The role also provides oversight of provider programs and contracting practices that advance quality performance, value-based initiatives, and total cost of care objectives.
Nature and Scope
This leadership position has broad accountability for provider contracting strategy, network development, and operational oversight across assigned functions. The incumbent translates organizational priorities into strategic and operational plans, establishes goals and resource priorities, and provides direction to achieve performance, service, and compliance objectives. The role requires the exercise of sound judgment, executive presence, and the ability to lead complex initiatives in a dynamic healthcare environment.
The position directs contract strategy, provider relationship management, and network performance activities to support access, affordability, quality, and regulatory compliance. Responsibilities include negotiating and interpreting complex contractual arrangements, monitoring performance against contractual and operational expectations, identifying risks and opportunities for improvement, and collaborating with internal and external stakeholders to strengthen provider alignment and service delivery.
The incumbent is expected to support continuous improvement through data-informed analysis, market assessment, and cross-functional planning. This position develops and maintains effective working relationships, promotes standardized processes and best practices, and advances strategies that strengthen provider alignment, operational effectiveness, and long-term network sustainability.
This position does not provide patient care
Disclaimer
The foregoing description is not intended to be, and should not be construed as, an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
Minimum Qualifications
Requirements - Required and/or Preferred
Name
Description
Education:
Ability to read, write, speak, and understand English sufficiently to perform job duties safely and effectively. Bachelor's degree in Business Administration or related field, Masters degree preferred.
Experience:
8 or more years of relevant managed care/health care contracting management experience.
License(s):
None
Certification(s):
None
Computer / Typing:
Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
