Director of Contracting

Antidote Health; Texas; Remote; USD 155,000 - 185,000; Full time

Benefits offered by this job

Equity participation

401(k)

Paid vacation and sick time

Job summary

Antidote Health is seeking a Director of Provider Contracting to lead negotiations and management of physician, hospital, behavioral health, and ancillary contracts within Texas, with emphasis on ACA Marketplace and commercial lines. You will design competitive reimbursement methodologies and partner with Legal, Finance, Operations, and Product to sustain a high‑performing network.

The role requires deep payer‑provider contracting expertise in Texas, strong financial acumen, and proven

Qualifications

• Bachelor’s degree in Business, Healthcare Administration, Finance, or a related field.
• Minimum of 7 years of progressive provider contracting experience.
• Minimum of 3 years of management experience, including hiring and team development.
• Experience contracting with Texas-based provider systems, hospital networks, and physician groups.
• Primary focus on ACA Marketplace and commercial lines of business; demonstrated success negotiating and managing contracts in these segments.
• Hands‑on expertise with percentage of Medicare, case rates, and fee schedules; ability to model and compare structures to optimize cost and network competitiveness.
• Strong financial acumen with ability to analyze rate scenarios and present recommendations to leadership.
• Proven negotiation skills and ability to manage complex, multi‑party contract discussions.
• Excellent written and verbal communication skills; ability to present clearly to executive stakeholders and provider partners.

Responsibilities

• Lead contracting with physicians, hospitals, behavioral health providers, and ancillary facilities in Texas, focusing on ACA Marketplace and commercial lines.
• Structure and apply reimbursement methodologies (percent of Medicare, case rates, fee schedules) for competitive pricing across provider types.
• Clearly communicate contract terms, payment structures, and rate schedules to stakeholders and partners.
• Analyze the financial impact of contract terms and model rate scenarios to inform leadership.
• Collaborate with Network leadership to design enterprise network strategies aligned with regulatory requirements.
• Identify network gaps and recruit/onboard providers to meet coverage and adequacy standards.
• Maintain up-to-date provider directories, contract documentation, and databases.
• Monitor network performance metrics and drive provider engagement and contract compliance.
• Act as thought leader to foster accountability, collaboration, and continuous improvement.

Skills

Provider contracting

Negotiation

Leadership

Financial analysis

Regulatory compliance

Cross-functional collaboration

Contract management

Education

Bachelor's degree in Business/Healthcare/Finance

MBA / MHA

Juris Doctor (JD)

Tools

Cognizant contract management

QNXT modeling

Job description

Antidote Health is a tech- driven health insurance company on a mission to make healthcare easy, accessible, and more affordable. We’re rethinking how healthcare works—using technology to remove the friction, complexity, and delays that define the traditional system. Instead of navigating paperwork, long waits, and disconnected experiences, we’re building a simpler, more connected way for people to get care.

Our platform combines health coverage, virtual care, and a modern member experience into one seamless system designed to help people actually use their benefits.

We offer Affordable Care Act (ACA) health plans in Arizona and Ohio, and we’re growing quickly. We’re building a company focused on solving real problems—with real impact on people’s lives.

Position Overview

The Director of Provider Contracting is responsible for developing, negotiating, and managing physician, hospital, behavioral health, and ancillary provider contracts across Antidote Health’s Texas network. With a primary focus on ACA Marketplace and commercial lines of business, this leader will design and implement competitive reimbursement methodologies — including percent of Medicare, case rates, and fee schedules — maintain a high-performing provider network, and drive contracting strategies aligned with Antidote Health’s mission and growth objectives.

Reporting to the Head of Network, this role requires deep expertise in payer-provider contracting within the Texas market, strong financial acumen, and the ability to lead and inspire a team in a dynamic, fast-paced environment. The Director will collaborate cross-functionally with Legal, Finance, Operations, and Product to build and sustain a differentiated provider network.

Key Responsibilities

Contract Negotiation & Execution

• Lead the initiation, negotiation, and execution of contracts with physicians, hospitals, behavioral health providers, and ancillary facilities across the Texas market, with a focus on ACA Marketplace and commercial lines of business.
• Structure and apply a range of reimbursement methodologies — including percent of Medicare, case rates, and fee schedules — to achieve competitive, sustainable contract pricing across all provider types.
• Communicate contract terms, payment structures, and rate schedules clearly to internal stakeholders and provider partners.
• Analyze the financial impact of contract terms, model rate scenarios across reimbursement structures, and make data-driven recommendations to leadership.
• Collaborate with Network leadership to design and execute enterprise network strategies aligned with regulatory requirements and market needs.
• Identify network gaps and work proactively to recruit and onboard providers to meet coverage and adequacy standards.
• Maintain up-to-date provider directories, contract documentation, and databases within Antidote Health’s contracting management systems.
• Monitor network performance metrics and lead initiatives to improve provider engagement and contract compliance.
• Act as thought leader in collaboration team of contracting professionals, fostering a culture of accountability, collaboration, and continuous improvement.

Compliance & Strategic Contribution

• Ensure all provider agreements comply with applicable federal and state regulations, including ACA Marketplace requirements, Texas Department of Insurance rules, and commercial plan standards.
• Provide strategic input into Antidote Health’s broader network and business development plans.
• Stay current on industry trends, regulatory changes, and competitive benchmarks; translate insights into actionable contracting strategies.

Qualifications

Required:

• Bachelor’s degree in Business, Healthcare Administration, Finance, or a related field.
• Minimum of 7 years of progressive provider contracting experience, encompassing all provider types (physician, hospital, behavioral health, ancillary).
• Minimum of 3 years of management experience, including hiring, performance management, and team development.
• Established experience contracting with Texas-based provider systems, hospital networks, and physician groups.
• Primary focus on ACA Marketplace and commercial lines of business; demonstrated success negotiating and managing contracts in these segments.
• Hands‑on expertise with key reimbursement methodologies including percent of Medicare, case rates, and fee schedules; ability to model and compare structures to optimize cost and network competitiveness.
• Strong financial acumen with demonstrated ability to analyze rate scenarios, interpret contracting financials, and present recommendations to leadership.
• Proven negotiation skills and the ability to manage complex, multi‑party contract discussions.
• Excellent written and verbal communication skills; ability to present clearly to executive stakeholders and provider partners.

Preferred:

• Master’s degree (MBA, MHA) or Juris Doctor (J.D.).
• Experience in ACA small group and commercial ICHRA products.
• Experience with Cognizant and QNXT contract management and modeling systems.
• Familiarity with digital health, telehealth provider contracting, or virtual‑first care networks.
• Experience executing contracting functions in a startup or high‑growth health plan or health tech environment.
• Strong negotiation skills and the ability to manage complex, multi‑party contract discussions
• Financial acumen, with the ability to model rate scenarios and translate contracting financials into clear recommendations
• Ability to lead and develop a team in a dynamic, fast‑paced environment
• Strong cross‑functional collaboration with Legal, Finance, Operations, and Product
• Clear, confident communication with executive stakeholders and provider partners

This is a remote position with a strong preference for candidates located in Texas — ideally in the El Paso, San Antonio, Laredo, Corpus Christi, Dallas‑Fort Worth, Houston, or Austin metro areas — to support periodic in‑person collaboration with provider partners and internal leadership. Occasional travel within Texas and to other markets may be required for provider relationship management, network development, and team meetings. We will not be considering candidates outside of Texas at this time.

Compensation and Benefits

• Base salary range: $155,000 – $185,000 (commensurate with experience)
• Eligibility for equity participation
• 401(k)
• Paid vacation and sick time and company holidays

Company Standards and Expectations

• Employment is at‑will, meaning either the employee or the company may terminate employment at any time, with or without cause, in accordance with applicable law
• Employees are expected to adhere to all company policies, including confidentiality, data protection, and code of conduct
• Responsibilities may evolve based on business needs, and flexibility is expected as the company scales
• Compliance with all applicable federal, state, and local laws and regulations is required

Equal Opportunity Statement

Antidote Health is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other protected status under applicable law.