Director, Strategic Network Contracting

CareMore Health; California; On-site; USD 157,000 - 236,000; Full time

Job summary

CareMore Health seeks a Director, Network Contracting to lead strategy, development, and oversight of hospital and ancillary networks in California, ensuring high-quality, cost-effective care across Medicare Advantage, Medicaid, and managed care populations.

The role directs a small team responsible for negotiating, implementing, and administering agreements, focusing on access, affordability, quality, and member experience, with collaboration across finance, operations, and clinical teams.

Responsibilities

• Develop and execute the hospital and ancillary contracting strategy across multiple provider segments and geographic markets.
• Guide negotiations for high-value, strategically significant agreements and serve as executive sponsor for complex negotiations.
• Oversee reimbursement strategies and value-based contracting initiatives to improve patient outcomes and financial sustainability.
• Ensure timely execution, implementation, and ongoing administration of hospital and ancillary agreements while maintaining compliance with policies and regulatory requirements.
• Monitor contract performance and address network gaps and contracting opportunities while controlling medical expense and reducing cost of care.
• Leverage analytics and market intelligence to evaluate performance and identify contracting opportunities.
• Lead, coach, and develop a high-performing contracting organization and establish clear performance expectations.

Job description

CareMore Health seeks a Director, Network Contracting to lead strategy, development, and oversight of hospital and ancillary networks in California, ensuring high-quality, cost-effective care across Medicare Advantage, Medicaid, and managed care populations.

The role directs a small team responsible for negotiating, implementing, and administering agreements, focusing on access, affordability, quality, and member experience, with collaboration across finance, operations, and clinical teams.