As aProvider Contracting Advisor,you’llreport to the AVP, ProviderNetwork Management. In this individual contributor role, you’llassist in developing the strategic direction and management of day-to-day contracting and network management.

This is a hybrid position based in Raleigh, NC.

Responsibilities 

• Manage complex fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems.  

• Lead key market contracting strategy projects with responsibility for managing direct reports as assigned. 

• Build and maintain strong provider relationships to support network growth and value-based business opportunities. 

• Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure aligned execution. 

• Develop strategic network positions, identify value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics. 

• Work to meet unit cost targets while maintaining an adequate, competitive provider network. 

• Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics. 

• Prepare, review, and project the financial impact of large or complex provider contracts and alternative terms. 

• Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration. 

• Lead resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance. 

Required Qualifications 

• 3-5+ years of healthcare provider contracting and negotiating experience involving complex physician groups and ancillaries  

• Background in managed care, healthcare, or health insurance, including commercial contracting  

• Proven leadership experience, including mentoring and guiding others 

• Strong provider relationship management skills and success developing long-term-partnerships

• Knowledge of complex reimbursement methodologies, including incentive-based models (strongly preferred)

• Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences

• Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization 

• Customer-centric approach, strong interpersonal skills, and confidence in navigating change

• Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills

• Proficiencyin Microsoft Office

Preferred Qualifications 

• Bachelor’s degree in a related field (industry experience may substitute); MBA / MHA preferred