About this role

Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures
Oversee provider contracting activities to ensure efficiency and maintain compliance with the business unit’s policies and standards, government laws and regulations
Implement development activities for the recruitment and contracting of provider networks in new and prospective markets, and existing market expansions
Support new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources
Perform complex financial analyses to identify medical cost improvement opportunities, develop strategies to reach financial goals, and execute contracting strategies to meet goals and objectives
Oversee contracting and network development staff and external consultants in the development of provider networks for new and expansion markets
Monitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning
Ability to travel

Bachelor's degree in Business Administration, Health Care Administration, related field or equivalent experience
7+ years of combined contracting, network development or provider relations experience
Previous experience in Medicaid/Medicare contracting and negotiating hospital, large physician groups and ancillary service agreements
Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff
Valid driver's license
Applicants must be in the state of Pennsylvania to be considered for this role

Director, Contracting & Network Development

Key skills