Remote Texas Provider Contracting Director

Antidote Health

Texas

Remote

USD 155,000 - 185,000

Full time

8 days ago

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Benefits offered by this job

Equity participation

401(k)

Paid vacation and sick time

Job summary

Antidote Health is seeking a Director of Provider Contracting to lead negotiations and management of physician, hospital, behavioral health, and ancillary contracts within Texas, with emphasis on ACA Marketplace and commercial lines. You will design competitive reimbursement methodologies and partner with Legal, Finance, Operations, and Product to sustain a high‑performing network.

The role requires deep payer‑provider contracting expertise in Texas, strong financial acumen, and proven

Qualifications

Bachelor’s degree in Business, Healthcare Administration, Finance, or a related field.
Minimum of 7 years of progressive provider contracting experience.
Minimum of 3 years of management experience, including hiring and team development.
Experience contracting with Texas-based provider systems, hospital networks, and physician groups.
Primary focus on ACA Marketplace and commercial lines of business; demonstrated success negotiating and managing contracts in these segments.
Hands‑on expertise with percentage of Medicare, case rates, and fee schedules; ability to model and compare structures to optimize cost and network competitiveness.
Strong financial acumen with ability to analyze rate scenarios and present recommendations to leadership.
Proven negotiation skills and ability to manage complex, multi‑party contract discussions.
Excellent written and verbal communication skills; ability to present clearly to executive stakeholders and provider partners.

Responsibilities

Lead contracting with physicians, hospitals, behavioral health providers, and ancillary facilities in Texas, focusing on ACA Marketplace and commercial lines.
Structure and apply reimbursement methodologies (percent of Medicare, case rates, fee schedules) for competitive pricing across provider types.
Clearly communicate contract terms, payment structures, and rate schedules to stakeholders and partners.
Analyze the financial impact of contract terms and model rate scenarios to inform leadership.
Collaborate with Network leadership to design enterprise network strategies aligned with regulatory requirements.
Identify network gaps and recruit/onboard providers to meet coverage and adequacy standards.
Maintain up-to-date provider directories, contract documentation, and databases.
Monitor network performance metrics and drive provider engagement and contract compliance.
Act as thought leader to foster accountability, collaboration, and continuous improvement.