Executive Director, Provider Relations – Contracting

Jobtailor; Town of Florida (NY); On-site; USD 150,000 - 230,000; Full time

Job summary

Jobtailor seeks a Senior Leader for Medicaid network management to drive provider relations and contracting strategy across Southeast markets with executive engagement across health systems and provider groups.

You will oversee network development, contract negotiations, and regulatory compliance, using data-driven insights to improve provider experience and market performance while guiding cross-functional teams and ensuring network adequacy.

Qualifications

• 10+ years in Medicaid network management or related healthcare leadership.
• 5+ years leading provider-facing or network management teams.
• Experience with Medicaid programs and state regulatory environments.
• Ability to influence senior leaders and manage complex provider relationships.
• Bachelor's degree or equivalent.
• Experience in large-scale multi-state markets.
• Strategic leadership and market-focused decision making.
• Executive communication and data-driven decision making.

Responsibilities

• Lead provider relations and contracting strategy across the Southeast Medicaid region.
• Develop provider engagement plans for market growth and network expansion.
• Establish executive-level relationships with health systems, physician organizations, FQHCs, behavioral health providers, and community-based organizations.
• Identify opportunities to expand access in rural, underserved, and high-growth communities.
• Drive provider satisfaction, value-based relationships, and provider service experience improvement initiatives.
• Align provider relations and contracting activities with market priorities, growth objectives, regulatory requirements, and business performance goals.
• Serve as a senior Network leader and trusted partner to market, regional, compliance, operations, clinical, and government programs leadership.
• Oversee provider outreach, education, issue resolution, escalation management, and ongoing provider engagement.

Skills

Provider Contracting

Network Development

Data-Driven Decision Making

Analytical Skills

Business Acumen

Communication Skills

Relationship Building

Negotiation Skills

Change Leadership

Talent Development

Education

Bachelor's degree or equivalent

Job description

• Lead provider relations and contracting strategy across the Southeast Medicaid region
• Develop provider engagement plans addressing market growth, network expansion, and competitive provider dynamics
• Establish executive-level relationships with major health systems, physician organizations, FQHCs, behavioral health providers, ancillary providers, and community-based organizations
• Identify opportunities to expand access in rural, underserved, and high-growth communities
• Support strategic provider negotiations strengthening network adequacy, affordability, and long-term provider partnerships
• Drive provider satisfaction, value-based relationships, and provider service experience improvement initiatives
• Align provider relations and contracting activities with market priorities, growth objectives, regulatory requirements, and business performance goals
• Serve as a senior Network leader and trusted partner to market, regional, compliance, operations, clinical, and government programs leadership
• Oversee provider outreach, education, issue resolution, escalation management, and ongoing provider engagement
• Use provider feedback and market insights to improve provider experience and reduce avoidable friction
• Provide executive oversight of Medicaid provider contracting strategy, negotiation support, and network development priorities
• Ensure network adequacy standards are met and sustained
• Support complex provider negotiations and strategic contracting initiatives balancing affordability, access, quality, and partnership objectives
• Ensure activities align with state Medicaid contracts, regulatory requirements, audit standards, and internal policies
• Partner with Compliance, Legal, and Government Programs teams on regulatory issues, corrective actions, and risk mitigation
• Maintain readiness for state reviews, audits, reporting requests, and network adequacy validations
• Use data, reporting, and provider performance insights to evaluate network health, provider satisfaction, access, issue trends, and operational effectiveness
• Develop executive-level reporting, recommendations, and business updates for senior leadership
• Partner cross-functionally to resolve complex provider issues related to access, claims, operations, reimbursement, and service experience
• Lead and develop provider-facing and contracting colleagues through performance expectations, accountability, coaching, and talent development plans
• Foster a collaborative, inclusive, and market-focused culture centered on execution, continuous improvement, and provider partnership
• Support workforce planning, succession planning, and change leadership as work transitions into local market structures

Requirements

• Must live in Southeast region
• 10+ years of progressive experience in Medicaid network management, provider relations, provider contracting, managed care, or a related healthcare leadership role
• 5+ years of leadership experience managing provider-facing, contracting, or network management teams
• Demonstrated experience working in Medicaid programs and navigating complex state regulatory environments
• Proven ability to influence senior leaders, manage complex provider relationships, and lead execution in a matrixed organization
• Strong analytical, communication, negotiation, and relationship-building skills
• Bachelors degree or equivalent
• Experience leading Medicaid provider relations or contracting in large-scale, multi-state markets
• Experience managing complex provider systems and competitive provider environments
• Knowledge of Southeast Medicaid programs and provider ecosystems
• Experience supporting network growth, access expansion, and provider experience improvement initiatives
• Strategic leadership and market-focused decision making
• Medicaid market expertise and regulatory acumen
• Provider relationship management and stakeholder influence
• Contract negotiation and network development
• Business, financial, and operational acumen
• Change leadership and continuous improvement
• Executive communication and data-driven decision making
• Talent development and organizational leadership

Core Competencies

Demonstrates extensive experience in Medicaid network management and provider relations, with a strong focus on strategic leadership, contract negotiation, and stakeholder influence. Proven ability to drive provider satisfaction and network growth while ensuring compliance with regulatory standards.

Highest-signal resume keywords

• Medicaid Network Management
• Provider Relations
• Contract Negotiation
• Regulatory Compliance
• Strategic Leadership

Hard Skills

• Provider Contracting
• Network Development
• Data-Driven Decision Making
• Analytical Skills
• Business Acumen

Soft Skills

• Communication Skills
• Relationship Building
• Negotiation Skills
• Change Leadership
• Talent Development

Industry Keywords

• Southeast Medicaid Programs
• Provider Ecosystems
• Market Growth
• Access Expansion
• Stakeholder Influence