Director, Network Contracting

5 days ago

Boston, MA, United States The MH Group, LLC Full time

Our client, a leading health insurance organization, is seeking a dynamic Director of Network Contracting to lead provider contracting strategy and execution. This leader will be responsible for negotiating, developing, and managing provider networks that deliver both quality outcomes and cost-effective care. The Director will play a key role in maintaining strong relationships with healthcare providers, ensuring compliance with regulatory standards, and supporting the company's mission to improve member access and value.

Key Responsibilities

  • Lead contract negotiations with hospitals, physician groups, and ancillary providers to develop competitive and sustainable provider networks.
  • Oversee end-to-end network development, including identifying gaps, setting strategies, and ensuring adequacy for regulatory compliance.
  • Collaborate with executive leadership to align network contracting strategies with organizational goals.
  • Build and maintain positive relationships with providers to foster collaboration and resolve issues effectively.
  • Monitor and analyze provider performance, reimbursement trends, and market dynamics to inform contracting strategy.
  • Manage and mentor a team of network contracting professionals, fostering a culture of accountability, innovation, and continuous improvement.
  • Ensure compliance with federal, state, and accreditation requirements in all contracting activities.
Requirements
  • Bachelor's degree in Business, Healthcare Administration, or related field (Master's preferred).
  • Minimum 7-10 years of progressive experience in provider contracting, network management, or managed care, with at least 3-5 years in a leadership role.
  • Deep knowledge of healthcare reimbursement methodologies, provider relations, and regulatory requirements.
  • Strong negotiation, analytical, and relationship management skills.
  • Proven ability to lead cross-functional teams and drive results in a complex healthcare environment.
  • Excellent communication and leadership skills, with the ability to influence stakeholders at all levels.
Compensation & Benefits
  • Competitive base salary with performance-based incentives.
  • Comprehensive health, dental, vision, and retirement benefits.
  • Generous paid time off and wellness programs.
  • Professional growth and leadership development opportunities.


Salary Description

175,400

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