Director, Network Strategy (Marketplace) - REMOTE

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

Job summary

An established industry player is seeking a Network Director to lead strategic planning and development of provider networks. This pivotal role involves managing a high-performing team, negotiating contracts, and enhancing provider relationships to ensure quality and accessibility. The ideal candidate will have extensive experience in network relations and a deep understanding of reimbursement structures. Join a dynamic organization that values innovation and collaboration, offering competitive compensation and benefits to support your professional growth.

Qualifications

• 8+ years in network relations and development.
• 7+ years in a leadership role managing networks.

Responsibilities

• Leads strategy for provider network development and management.
• Negotiates with complex providers to maintain network quality.

Skills

Network relations

Contract negotiation

Provider management

Value-based payment models

Financial analysis

Education

Bachelor's degree

MBA or Master's degree

Job description

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Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking a Network Director. Apply via Lensa today!

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 in compliance with federal and state laws. Negotiates and services larger, complex market/national/group providers to maintain and improve network quality, accessibility, and affordability. Responsibilities may vary by market and can 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 expansion markets and addresses gaps.
• Ensures service levels meet or exceed expectations through provider engagement.
• Negotiates with and supports complex providers, ensuring compliance and meeting financial and quality goals.
• Leads a high-performing team to develop and maintain provider relationships, ensuring network competitiveness and profitability.
• Advances value-based payment models and oversees their implementation.
• Recruits diverse provider specialties to meet 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 working with provider systems.
• 7+ years in a leadership role managing networks and negotiating contracts.
• Deep knowledge of reimbursement structures and payment methodologies.
• Experience with value-based contracting.
• Understanding of managed care, regulations, products, and strategies.
• Knowledge of hospital and physician financial issues and leveraging technology for quality and cost improvements.
• Ability to travel up to 20% within primary states.

Preferred Education

MBA or Master's degree preferred

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

Molina Healthcare offers competitive benefits. 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.

Additional Details

• Seniority level: Director
• Employment type: Full-time
• Job function: Information Technology
• Industries: IT Services and Consulting