Medicaid Provider Relations & Network Strategy Lead

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

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.