National Director, Provider Contracting & Network Strategy

Network Business Solutions; Richardson (TX); Remote; USD 162,000 - 300,000; Full time

Job summary

HCSC is seeking a senior professional to oversee provider relations and the development and management of contracting strategies for statewide operations relative to commercial HMO and PPO products. The role also handles reimbursement contract negotiations and hospital network servicing for Medicare Advantage and Medicaid programs.

This position ensures contracted network coverage and oversight of contracting operations nationally.

Qualifications

• Bachelor degree in health care administration required.
• Extensive experience in health care/insurance contracting and provider relations.
• Strong negotiation and leadership capabilities expected.

Responsibilities

• Develop and manage contracting strategies for statewide operations relative to commercial HMO and PPO.
• Negotiate and finalize reimbursement contracts; ensure network coverage across locations.
• Draft agreements for hospitals and large providers for Commercial HMO/PPO, Medicare Advantage and Medicaid networks.
• Oversee hospital audits and ensure appropriate reimbursement of costs.
• Lead staff, manage budgets, and report operational and financial performance.
• Maintain HIPAA compliance and professional communication with stakeholders.

Skills

Negotiation skills

Leadership

Communication skills

Travel willingness

Financial acumen

Education

Bachelor degree in health care administration

Job description

HCSC is seeking a senior professional to oversee provider relations and the development and management of contracting strategies for statewide operations relative to commercial HMO and PPO products. The role also handles reimbursement contract negotiations and hospital network servicing for Medicare Advantage and Medicaid programs.

This position ensures contracted network coverage and oversight of contracting operations nationally.