Director, Provider Contracting & Network Strategy

MetroPlusHealth; New York (NY); On-site; USD 140,000 - 210,000; Full time

Job summary

MetroPlusHealth is seeking a Director of Provider Contracting in New York to lead the contracting of a comprehensive provider network and oversee a team focused on improving member and employee experience. The role requires deep health plan knowledge, strategic negotiation, and regulatory compliance.

Travel throughout the MetroPlusHealth service area is required. This leadership position demands extensive experience in payer contracting, network development, and stakeholder collaboration with

Qualifications

• Bachelor's degree required plus 10+ years in Health Plan environment with contracting/reimbursement exposure.
• 7+ years of payer experience including contract strategies across multiple products.
• 7 years of expertise in quality improvement strategies.
• Knowledge of managed care administration, regulations, and HR principles.

Responsibilities

• Oversee contracting physicians, medical groups, and ancillary providers.
• Negotiate contracts compliant with templates and process controls.
• Manage cost budgets, targets, and performance reporting.
• Forecast contract renewal strategy and maintain provider networks.
• Collaborate with Credentialing, Provider Maintenance, and Core Configuration units to implement contracts efficiently.
• Ensure regulatory compliance in all agreements.
• Draft and coordinate contract amendments within required timeframes.
• Lead and develop the Contracting team and oversee key contracting efforts.

Skills

Leadership

Contract negotiation

Strategic planning

Regulatory compliance

Communication skills

Travel flexibility

Education

Bachelor’s degree in Business Administration, healthcare, legal studies or related field

Tools

Microsoft Office

Job description

MetroPlusHealth is seeking a Director of Provider Contracting in New York to lead the contracting of a comprehensive provider network and oversee a team focused on improving member and employee experience. The role requires deep health plan knowledge, strategic negotiation, and regulatory compliance.

Travel throughout the MetroPlusHealth service area is required. This leadership position demands extensive experience in payer contracting, network development, and stakeholder collaboration with