Senior Director, Provider Contracting & Network Strategy (Remote)

HCSC; Chicago (IL); Remote; USD 121,000 - 225,000; Full time

Job summary

Health Care Service Corporation in the United States seeks an experienced healthcare contracting leader to develop and manage network strategies for commercial and government networks. You will oversee contracting operations, negotiate reimbursement agreements, and ensure network adequacy while guiding staff and budgets with HIPAA and compliance oversight.

The role emphasizes building trust with provider leadership, managing complex reimbursement strategies, and delivering cost-effective

Qualifications

• Bachelor’s degree plus 5 years’ experience in hospital/health care contracting or hospital/physician relations.
• 5 years management experience.
• Experience with large integrated health care delivery systems and complex reimbursement strategies.
• Experience proactively developing and maintaining relationships with health care provider leadership teams.
• Knowledge of outpatient and provider reimbursement strategies and policies.
• Experience with financial matters such as contract performance and impact including accuracy and sound judgment.
• Experience proactively developing creative, win-win solutions considering impact on provider contracts and profitability.
• Experience meeting deadlines and working under pressure.
• Ability and willingness to travel, including overnight stays.
• Overseeing budget and allocating resources for projects.

Responsibilities

• Develop and manage contracting strategies for operations relative to commercial and government networks.
• Accountable for the development, negotiation, and successful completion of reimbursement contracts; ensure network adequacy.
• Develop network, draft reimbursement agreements, and negotiate contracts for hospitals and large groups with special pricing.
• Achieve competitive advantage in discounts and access through contract negotiations and relationship management.
• Develop strategies, draft agreements, and negotiate contracts for newly recognized categories of providers.
• Oversee the analysis and reporting required to develop reimbursement strategies and take corrective action.
• Accountable for resolution of issues and contractual disputes.
• Ensure staff meets/exceeds goals; ensure training, staffing, and communications on changes.
• Accountable for budget, operational reporting, and financial reporting.
• Communicate effectively with management, customers, and colleagues.
• Comply with HIPAA, Diversity Principles, Compliance Program policies, and other policies.
• Maintain complete confidentiality of company related business.
• Maintain effective communication with leadership and perform special projects as required.

Skills

Negotiation skills

Leadership skills

Communication skills

Team player

Relationship building

Travel willingness

Education

Bachelor’s degree

Job description

Health Care Service Corporation in the United States seeks an experienced healthcare contracting leader to develop and manage network strategies for commercial and government networks. You will oversee contracting operations, negotiate reimbursement agreements, and ensure network adequacy while guiding staff and budgets with HIPAA and compliance oversight.

The role emphasizes building trust with provider leadership, managing complex reimbursement strategies, and delivering cost-effective