Director, Network Partnerships & Contracting
New
J
JobgetherHealthcare
Based in the United StatesFull-TimeDirector
Salary not disclosed
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Job Details
- Experience
- 8+ years
- Required Skills
- Data Analysis
Requirements
- Bachelor's degree or equivalent practical experience.
- 8+ years of experience in provider contracting, network management, healthcare reimbursement, or network strategy.
- Deep knowledge of provider payment methodologies, including DRGs, case rates, per diems, percentage-of-charges arrangements, and fee schedules.
- 5+ years of experience in contracting or network roles supporting commercial group markets and employer-sponsored health plans.
- Strong understanding of TPA, ASO, and/or leased-network arrangements and their implications for network strategy.
- 5+ years of experience independently drafting and negotiating complex healthcare agreements, including direct agreements with hospitals, health systems, and physician groups.
- 4+ years of experience ensuring healthcare contracts and provider networks meet federal and state regulatory requirements, including state network adequacy standards and the No Surprises Act.
- 3+ years of experience developing and negotiating value-based care arrangements, including shared savings, risk-based models, bundled payments, or pay-for-performance structures.
- 2+ years of cross-functional experience bringing network products to market, partnering with cross-functional teams to define go-to-market strategies.
- Strong analytical and commercial judgment, with the ability to evaluate complex network economics.
- Excellent negotiation, relationship-building, communication, and executive-facing presentation skills.
Responsibilities
- Lead the development and execution of new provider network partnerships, identifying priority markets, evaluating partnership models, and negotiating agreements through signature and implementation.
- Own new network launches end to end, ensuring networks are competitively priced, operationally ready, compliant, and launched according to established timelines.
- Analyze market intelligence, network economics, reimbursement rates, competitor positioning, and regulatory developments to inform market-entry and network strategy decisions.
- Negotiate complex healthcare agreements with providers, hospitals, health systems, physician groups, network partners, and vendors, including high-value provider recoupments.
- Ensure network contracts and operations satisfy applicable federal and state requirements, including network adequacy standards and requirements associated with the No Surprises Act.
- Own contract lifecycle management, maintaining the contract repository as the single source of truth and monitoring renewals, terminations, notices, escalators, amendments, and reporting obligations.
- Serve as the senior escalation point for provider and vendor contract disputes, driving issues toward timely and commercially sound resolutions.
- Collaborate cross-functionally with Sales, Product, Marketing, Engineering, Finance, Actuarial, and Compliance to translate network capabilities into scalable products and compelling market propositions.
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