Position Summary:

The Director of Provider Network Strategy & Contracting is responsible for managing the health plan's end-to-end provider network. They are responsible for the overall contracting strategy, advancing affordability and quality goals, and driving competitive market performance across the Medicaid, Medicare, and Commercial lines of business. This role is responsible for ensuring access, competitive positioning, and alignment with product and market objectives. They identify network gaps, analyze network performance, and lead strategic contracting initiatives that strengthen the plan's market presence. This leadership position is responsible for all value-based and alternative payment arrangements, supporting new market entry, conducting due diligence to guide expansion decisions, maintaining strong provider partnerships, and ensuring the network is positioned to support growth, differentiation, and regulatory readiness. This position is responsible for leading cross functional governance across the clinical, financial, and operational teams, ensuring that network strategy aligns with affordability, quality, and performance priorities. They monitor provider network performance across cost, utilization, and quality outcomes, develop high impact provider engagement tools, and anticipate regulatory and industry shifts to keep the organization ahead of market change.

Qualifications:

Required:

• Bachelor's degree in business administration, healthcare administration, or related field.
• Eight (8) years of experience in provider network management, provider contracting, or value-based payment (VBP) to include three (3) years of experience in government programs (Medicaid, Medicare, MA/D SNP) while leading multi-market provider contracting or network development programs with at least three (3) years in a supervisory role leading or assisting in all phases of effective supervision (i.e. Recruitment, performance management, training).
• Valid state driver's license, reliable transportation, and automobile insurance coverage required and maintained throughout employment.

Preferred:

• Master's degree in business administration, healthcare administration, or related field.
• Direct experience in Michigan Managed Care markets and/or integrated delivery systems.
• Familiarity with actuarial concepts, risk adjustment, and population health analytics.