DescriptionRemote - TX Based | Reports to the COO
POSITION OVERVIEW
Harbor Health is looking for a VP of Network and Payor Relationships to lead both sides of our payvider model: the contracts we hold with outside payors on behalf of our medical group, and the provider network we build and manage for Harbor Health Insurance Company (HHIC). This is a senior leadership role reporting directly to our Chief Operating Officer, bringing together work that's currently split across multiple people into a single, accountable seat. You'll inherit an existing network operations team and shape how that team grows as Harbor Health scales across Texas.
POSITION DUTIES & RESPONSIBILITIES
- Own and negotiate medical group payor contracts, including reimbursement rates, network participation terms, and value-based arrangements with third-party payors.
- Lead network development and provider relations for HHIC, building and maintaining the provider network that supports our health plan.
- Manage and grow a team responsible for network operations, provider relations, and contracting support.
- Partner with Regulatory Affairs on TDI filings and network adequacy requirements for HHIC.
- Work with Legal on contract language and risk, ensuring compliance with Stark Law, the Anti-Kickback Statute, and HIPAA.
- Build and execute a unified payor and network strategy that aligns Harbor Health's medical group and health plan sides of the business.
- Track Texas payor and network market trends, and adjust strategy as competitive and regulatory conditions shift.
- Present network and payor strategy, team performance, and contract pipeline to the Harbor Leadership Team (HLT).
- Assess current team structure and roles, and build the org needed to support Harbor Health's network and payor strategy going forward.
DESIRED PROFESSIONAL SKILLS & EXPERIENCE
- 8-10+ years of experience in payor contracting, network development, or provider relations, including direct experience inside a health plan.
- Experience managing both sides of a payor relationship: negotiating with external payors and building a provider network for an internal health plan.
- People leadership experience, with a track record of managing and developing a team.
- Working knowledge of the Texas payor landscape, TDI regulatory requirements, and value-based contracting models.
- Familiarity with Stark Law, the Anti-Kickback Statute, and HIPAA as they apply to network contracting and provider relations.
- Bachelor's degree required; MBA, MHA, or JD preferred.
- Comfortable operating in a startup environment where processes and org structure are still evolving.
WHAT WE OFFER
- Opportunity to build and lead the team responsible for Harbor Health's network and payor strategy across our care delivery and health plan sides
- Collaborative and dynamic work environment
- An organization made of people who are passionate about changing the healthcare landscape
- Competitive salary and benefits package
- Professional development and growth opportunities
- A transparent and unique culture
