Director of Provider Network Strategy

Medical Mutual; Cleveland (OH); On-site; USD 120,000 - 170,000; Full time

Benefits offered by this job

On-site fitness centers

Gym membership reimbursement

On-site cafeteria

Discounts for employees

Cash rewards program

Business casual attire

Job summary

Medical Mutual, based in Ohio, seeks a Director of Provider Network Management to oversee provider relationships, negotiate contracts, and implement reimbursement strategies. The role aims to achieve best-in-market cost, access, and quality across regions.

Responsibilities include managing negotiations, building strong provider networks, and guiding teams toward improved outcomes and compliance with accreditation standards. A strong background in managed care and leadership is essential.

Qualifications

• Bachelor’s degree in Business Admin, Healthcare Admin, Finance, or related field.
• 8 years progressive experience in provider network development, managed care, or equivalent; 5 years in leadership.
• Master’s degree preferred (MBA or MHA).

Responsibilities

• Reviews proposed contracts and manages multiple negotiation processes to meet local/regional network targets.
• Establishes relationships with high-volume providers and health systems across all product offerings.
• Directs operations and staff including provider access, quality, satisfaction, and learning and development.
• Partners with Sales, Clinical, Network Informatics and others to meet customer satisfaction goals.
• Complies with regulatory standards and participates in accreditation activities.

Skills

Negotiation skills

Analytical thinking

Interpersonal skills

Communication

Education

Bachelor's degree in Business Administration, Healthcare Administration, Finance, or related field

MBA or MHA preferred

Tools

Microsoft Office

Job description

Medical Mutual, based in Ohio, seeks a Director of Provider Network Management to oversee provider relationships, negotiate contracts, and implement reimbursement strategies. The role aims to achieve best-in-market cost, access, and quality across regions.

Responsibilities include managing negotiations, building strong provider networks, and guiding teams toward improved outcomes and compliance with accreditation standards. A strong background in managed care and leadership is essential.