Director Provider Contracting & Relations

Employer Health Care Alliance Coop., Inc; Madison (WI); Hybrid; USD 131,000 - 139,000; Full time

Job summary

The Alliance seeks a Director of Provider Contracting & Relations to lead strategy and execution of contracting across markets, balancing cost, access, quality, and network competitiveness. You will negotiate with health systems, develop financial parameters, and ensure clear documentation and transition to implementation teams.

Travel up to 50% is required, and you will partner with Analytics, Finance, Legal, and Operations to advance employer-driven network strategies and value-based

Qualifications

• Bachelor’s degree required or equivalent experience.
• 7+ years in healthcare, health insurance, or provider network management.
• Proven experience leading complex provider negotiations and contracting strategies.
• Strong written, verbal, facilitation, negotiation, and executive-level presentation skills.

Responsibilities

• Lead development and execution of provider contracting strategies across markets and provider types.
• Lead and support complex negotiations with health systems and provider partners including renewals and new opportunities.
• Develop negotiation strategies, financial parameters, and trade-off scenarios using market data and priorities.
• Evaluate reimbursement methodologies and contract terms including fee schedules and value-based models.
• Identify risks and develop recommendations to support informed decision-making.

Skills

Provider contracting

Negotiation

Leadership

Strategic thinking

Cross-functional collaboration

Executive communication

Education

Bachelor’s degree in business, healthcare administration, finance, economics, or related field

Tools

Microsoft 365

Analytics tools

Contracting software

Job description

• Base Pay $131,000.00 - $139,000.00 / Year
• Job Category Healthcare / Healthcare Management, Provider Relations / Network Management, Contract Management / Contracting
• Industry Hospital & Health Care, Health Insurance, Managed Care
• Required Degree 4 Year Degree
• Travel 50%
• Manage Others Yes

Contact information

• Name Employee Experience at The Alliance
• Phone [phone]
• Email [e-mail]

Description

How You Will Contribute

• Lead development and execution of provider contracting strategies across markets and provider types, balancing cost, access, quality, network competitiveness, and long-term sustainability.
• Lead and support complex, high-impact negotiations with health systems and other provider partners, including contract renewals, reimbursement arrangements, amendments, new market opportunities, and escalated contractual issues.
• Develop negotiation strategies, objectives, financial parameters, and trade-off scenarios using market intelligence, contract performance, utilization trends, and organizational priorities.
• Evaluate reimbursement methodologies and contract terms, including fee schedules, percent-of-charge arrangements, case rates, bundled arrangements, value-based models, and other alternative payment structures.
• Identify contractual, financial, operational, and relationship risks; develop recommendations and escalation strategies to support informed decision-making.
• Ensure executed agreements and negotiated terms are clearly documented, operationally feasible, and effectively transitioned to the teams responsible for implementation and ongoing administration.

Provider Relationships & Network Performance

• Build and maintain productive, long-term relationships with provider executives, contracting leaders, and operational partners through transparency, credibility, and consistent follow-through.
• Serve as a senior point of escalation for complex provider relationship matters, balancing partnership objectives with The Alliance’s responsibility to employers and members.
• Monitor provider and contract performance using cost, utilization, access, market, and other available data; identify opportunities for renegotiation, intervention, or strategic development.
• Assess network gaps, provider opportunities, and market dynamics and recommend strategies that strengthen access, affordability, differentiation, and competitive position.
• Partner with providers to resolve systemic issues and improve the effectiveness of the provider relationship and member experience.

Leadership & Team Development

• Lead, coach, and develop provider contracting and relations team members; establish clear expectations, decision rights, priorities, and accountability for results.
• Build team capability in negotiation, relationship management, reimbursement strategy, market analysis, project execution, and effective cross-functional partnership.
• Create scalable workflows, standards, documentation, and operating rhythms that support consistent contracting practices and effective management of the provider portfolio.
• Allocate team resources and priorities based on organizational strategy, market needs, contract cycles, and emerging provider opportunities or risks.
• Foster a collaborative, accountable, learning-oriented culture that supports sound judgment, continuous improvement, and strong internal and external relationships.

Cross-Functional Strategy & Organizational Partnership

• Partner closely with Provider Relations leadership and colleagues across Analytics, Finance, Legal, Operations, Business Development/Employer Engagement, and other functions to develop and execute integrated provider strategies.
• Translate employer needs, market feedback, financial analysis, and network performance insights into actionable contracting and provider relationship priorities.
• Provide provider-market expertise and recommendations in organizational planning, product development, growth initiatives, and strategic decision-making.
• Communicate complex contracting issues, market dynamics, risks, and recommendations clearly to executive and senior leadership audiences.
• Ensure key stakeholders are appropriately engaged throughout contracting initiatives and understand decisions, dependencies, implementation requirements, and expected outcomes.
• Maintain a strong understanding of healthcare market trends, provider consolidation, reimbursement practices, regulatory developments, transparency requirements, and emerging payment and delivery models.
• Analyze external developments and competitive dynamics to anticipate potential impacts on The Alliance’s provider network and employer members.
• Identify and evaluate opportunities for new provider partnerships, market expansion, alternative contracting approaches, and solutions that improve healthcare value.
• Develop data-informed business cases and recommendations for contracting initiatives, provider strategies, and network investments.
• Lead complex provider-facing projects and contracting initiatives from strategy and planning through negotiation, implementation, and transition to ongoing ownership.
• Establish project objectives, milestones, stakeholder roles, decision points, risks, and communication expectations for major contracting initiatives.
• Evaluate and oversee vendors or external partners supporting contracting, network operations, data, or provider-facing work; monitor service, value, and performance.
• Champion effective use of systems, data, templates, tools, and process improvements that increase contracting discipline, visibility, efficiency, and scalability.
• Maintain appropriate documentation and support compliance with organizational policies, contractual obligations, and applicable regulatory requirements .

Requirements

Qualifications

• Bachelor’s degree in business, healthcare administration, finance, economics, or a related field, or an equivalent combination of education and relevant experience.
• Minimum of 7 years of progressively responsible experience in healthcare, health insurance, provider network management, or a related field, including at least 3 years of direct provider contracting and/or network management experience.
• Demonstrated experience leading complex provider negotiations and developing contracting strategies involving significant financial, operational, or relationship considerations.
• People leadership experience, including coaching, prioritization, delegation, accountability, and development of professional staff.
• Strong working knowledge of provider reimbursement methodologies, contract structures and language, network economics, and healthcare regulatory considerations.
• Demonstrated ability to interpret financial, utilization, market, and performance data and translate analysis into strategy and action.
• Experience leading cross-functional initiatives and influencing decisions across functions and levels without relying solely on formal authority.
• Excellent written, verbal, facilitation, negotiation, and executive-level presentation skills.
• Proficiency with Microsoft 365 applications and business reporting/analytics tools; ability to learn and effectively use contracting and network-management technologies.

Preferred Qualifications

• Experience negotiating with large health systems, independent provider groups, surgical centers, ancillary providers, or other complex provider organizations.
• Experience with self-funded employer health plans, employer coalitions, third-party administrators, or employer-sponsored healthcare strategies.
• Experience with value-based contracting, bundled payments, centers of excellence, reference-based approaches, or other alternative reimbursement and delivery models.
• Experience using healthcare claims, utilization, pricing, or market data to inform contracting strategy and evaluate provider performance.
• Experience with vendor management, contracting technology, or implementation of tools and processes that improve network operations.

Physical Requirements

• Regularly required to sit and work at a computer for extended periods and participate in virtual and in-person meetings.
• Frequently required to communicate verbally and in writing; occasionally required to stand or walk.
• Visual acuity sufficient to review detailed contracts, data, and computer-based information.
• Ability to travel regionally as needed for provider meetings, negotiations, organizational meetings, and industry events.
• Work outside standard business hours may occasionally be required to support negotiations, deadlines, travel, or other business needs.
• Remote work flexibility applies in accordance with organizational expectations; in-office workspace options may be available.

Summary

What to Know about the Job

The Director of Provider Contracting & Relations provides strategic and operational leadership for The Alliance’s provider contracting and relationship strategy. The role is accountable for developing and executing contracting approaches that strengthen network value, improve affordability, support access and market competitiveness, and advance The Alliance’s employer-driven mission.

This leader directs complex provider negotiations and relationship strategies across health systems, independent providers, surgical centers, ancillary providers, and other network partners. The Director uses market intelligence, contract and utilization data, reimbursement expertise, and strong provider relationships to identify opportunities, manage risk, and ensure contractual arrangements deliver sustainable value for employers and members.

As a people leader and cross-functional partner, the Director builds team capability, establishes disciplined contracting practices, and works closely with organizational leaders and subject-matter experts to translate strategy into measurable network outcomes.

Who We Are

At The Alliance, our mission is helping employers self-fund smart. We serve as the voice for self-funded employers who want more control over their healthcare costs and who believe that affordable, high-quality care should be accessible to everyone.

Why Work at The Alliance?

Along with the satisfaction you’ll receive from working with a mission-driven organization, you’ll join a humble, lively, and hard-working group of people. The Alliance is home to a highly collaborative, creative, and dedicated bunch; you’ll feel our warm friendliness, be fueled by our inspiring passion, and find support from us when you need it, too.