Director, Provider Network Contracting

Partners Health Management; Elkin (NC); Remote; USD 100,000 - 130,000; Full time

Job summary

A leading health management organization is seeking a Director of Provider Network Contracting to lead contract negotiations and manage provider relationships. This role requires extensive experience in network management and a passion for improving member experiences. The successful candidate will oversee complex negotiations, ensure compliance, and collaborate with various teams to enhance service delivery. Competitive compensation and a comprehensive benefits package are offered, including a remote option.

Benefits

Annual incentive bonus plan

Medical, dental, and vision insurance

Generous vacation and sick time accrual

12 paid holidays

State Retirement (pension plan)

401(k) Plan with employer match

Company paid life and disability insurance

Wellness Programs

Public Service Loan Forgiveness Qualifying Employer

Qualifications

• 8+ years in network management, including hospital contracting.
• 3+ years managing complex provider networks and contracts.

Responsibilities

• Manage all duties related to payor contracts, including negotiation.
• Collaborate with Provider Enrollment and Legal teams.
• Supervise and coach Contracts staff in regulatory matters.

Skills

Negotiation

Financial Analysis

Data Extraction

Communication

Presentation

Education

Bachelor's degree

Master's Degree

Tools

Microsoft Office

Job description

Join to apply for the Director, Provider Network Contracting role at Partners Health Management

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Join to apply for the Director, Provider Network Contracting role at Partners Health Management

Competitive Compensation & Benefits Package!

• Annual incentive bonus plan
• Medical, dental, and vision insurance with low deductible/low cost health plan
• Generous vacation and sick time accrual
• 12 paid holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company paid life and disability insurance
• Wellness Programs
• Public Service Loan Forgiveness Qualifying Employer

See attachment for additional details.

Location: Available for any of Partners' NC locations; Remote option

Projected Hiring Range: Depending on Experience

Closing Date: Open Until Filled

Primary Purpose Of Position

The Director Provider Network Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for Partners Health Management for the health products offered. The role involves managing complex contract negotiations, analyzing financial impacts, maintaining documentation, and providing leadership within the Contracts Unit.

Role And Responsibilities

• Manage all duties related to payor contracts, including negotiation and renegotiation within legal allowances
• Collaborate with Provider Enrollment and Legal teams to ensure proper contract management
• Possess knowledge of Managed Care and Payer Contracting activities
• Develop, coordinate, and analyze payor contracts
• Negotiate payment terms and rates favorably, under legal supervision as needed
• Review and ensure accurate implementation of contract terms
• Maintain contract templates and ensure compliance with regulatory requirements
• Monitor and renegotiate contract renewals
• Resolve escalated contract issues with legal oversight
• Supervise and coach Contracts staff in regulatory matters
• Negotiate provider contracts in compliance with templates, standards, laws, and regulations
• Support network growth forecasting and planning
• Manage performance metrics and financial models related to contracting
• Build and maintain strong provider and internal relationships
• Design and analyze reports for internal and external use
• Coordinate contract data analysis for audits and quality improvements
• Maintain accurate provider information and documentation
• Participate in quality improvement activities across departments
• Collaborate with other departments to ensure contract system compliance

Knowledge, Skills And Abilities

• Extensive provider contracting skills, including negotiations and financial analysis
• Ability to manage multiple priorities in a fast-paced environment
• Passion for improving member/recipient experiences
• Strong data extraction and analysis skills
• Excellent communication and presentation skills
• Proficiency with Microsoft Office and database use
• Ability to interpret policies and resolve problems independently
• Discretion in handling sensitive data

Education And Experience Required

• Bachelor's degree
• 8+ years in network management, including hospital contracting and provider negotiations
• 3+ years managing complex provider networks and contracts
• 2+ years in project leadership

Preferred Qualifications

• Master's Degree
• Experience with ACO/Risk Contracting and Value Based Contracting
• Paralegal background and healthcare payor systems experience