Director, Network Strategy (Marketplace) - REMOTE

Lensa; Idaho Falls (ID); Remote; USD 111,000 - 177,000; Full time

Job summary

A leading healthcare organization is seeking a Director of Provider Network Development to lead strategies for building and managing provider relationships. This role requires extensive experience in network relations, contract negotiations, and a deep understanding of managed care. The successful candidate will ensure network adequacy and compliance while leading a high-performing team.

Qualifications

• 8+ years in network relations and development.
• 7+ years in a leadership role with successful contract negotiations.
• Deep understanding of reimbursement structures.

Responsibilities

• Leads strategy and planning for provider network development.
• Develops and implements a geographically competitive access network.
• Engages with key providers to ensure service levels meet expectations.

Skills

Negotiation

Leadership

Strategic Planning

Network Development

Provider Relationship Management

Education

Bachelor's degree

MBA or Master's degree preferred

Job description

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Job Description

Job Summary

Leads the market's strategy and planning in the successful development of the provider network, including development, contracting, and management of provider relationships and communications. Manages a team responsible for developing, negotiating, contracting, and enhancing provider networks that are high quality, cost-efficient, and improve members' lives. Ensures network adequacy and access to member choice in compliance with federal and state laws. Negotiates and services larger and more complex market/national/group-based providers to maintain and enhance provider networks while meeting accessibility, quality, financial, and affordability goals. Responsibilities may vary by market and could be organized by services or contract types.

Knowledge/Skills/Abilities

• Leads strategy and planning for provider network development, contracting, and management.
• Develops and implements a geographically competitive, broad access network meeting cost and trend management objectives.
• Builds out network markets and addresses gaps.
• Engages with key providers to ensure service levels meet expectations.
• Evaluates and negotiates with complex providers, supporting compliance and goals.
• Leads a high-performing team to develop and maintain provider relationships, ensuring network competitiveness and profitability.
• Supports adoption of value-based payment models, overseeing implementation as needed.
• Recruits and maintains a diverse provider network aligned with membership needs.
• Collaborates with operations to resolve service issues, including claims, provider demographics, and credentialing.

Job Qualifications

Required Education

Bachelor's degree

Required Experience

• 8+ years in network relations and development, with experience building and maintaining provider relationships.
• 7+ years in a leadership role with successful contract negotiations and business results.
• Deep understanding of reimbursement structures and payment methodologies.
• Experience with value-based contracting.
• Knowledge of managed care, regulations, products, and strategies.
• Understanding of hospital and physician financial issues and leveraging technology for quality and cost improvements.
• Must reside in primary states and be able to travel up to 20% within the market.

Preferred Education

MBA or Master's degree preferred

Current Molina employees interested in this position should apply through the intranet.

Molina Healthcare offers competitive benefits and compensation. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $111,893 - $176,679 annually. Actual compensation varies based on location, experience, education, and skills.

Seniority level

• Director

Employment type

• Full-time

Job function

• Information Technology

Industries

• IT Services and IT Consulting