Senior Network Contracting Lead for Value-Based Care

CareMore Health; United States; Remote; USD 81,000 - 122,000; Full time

Job summary

CareMore Health seeks a Senior Network Contracting Analyst to lead complex physician and specialty provider agreements, manage the contract lifecycle from strategy through execution, and provide financial analysis to optimize network performance and value-based care.

You will collaborate with Finance, Legal, Compliance, Provider Operations, and Clinical leadership to implement agreements, assess reimbursement scenarios, monitor market conditions, and strengthen provider partnerships while

Responsibilities

• Lead negotiations for complex primary care and specialty provider agreements, managing the full contract lifecycle from strategy development through execution and implementation.
• Develop negotiation strategies by evaluating provider performance, reimbursement methodologies, market conditions, utilization trends, quality metrics, and competitive intelligence.
• Interpret complex financial models to assess reimbursement scenarios, contract economics, provider performance, and the financial impact of proposed contract terms.
• Structure provider agreements that balance medical expense and affordability initiatives, network adequacy, quality outcomes, regulatory compliance, and long-term provider partnerships.
• Collaborate with Finance, Legal, Compliance, Provider Operations, Configuration, Credentialing, and Clinical leadership to ensure accurate implementation and operational readiness of executed agreements.
• Analyze provider network adequacy, access standards, cost trends, utilization patterns, and market opportunities to recommend strategic contracting initiatives and network optimization strategies.
• Serve as the primary contracting contact for assigned provider organizations, resolving contract interpretation questions, reimbursement issues, and operational concerns while fostering collaborative provider relationships.
• Support the development and implementation of value-based payment arrangements, including shared savings, quality incentive, bundled payment, capitation, and other alternative reimbursement models.
• Identify contracting risks and opportunities, recommending solutions that improve provider performance, member access, quality outcomes, and financial sustainability.
• Lead cross-functional contracting projects and process improvement initiatives that enhance operational efficiency, contract governance, and data integrity.
• Prepare executive-level reports, financial analyses, and contracting recommendations for Network Management leadership.
• Stay current on CMS regulations, state Medicaid requirements, healthcare market trends, and industry best practices that impact provider contracting and reimbursement.
• Foster a sense of curiosity and desire to understand how various provider relationships interact with overall CareMore strategic initiatives.
• Pivot quickly and prioritize workload in line with changing organizational objectives.

Job description

CareMore Health seeks a Senior Network Contracting Analyst to lead complex physician and specialty provider agreements, manage the contract lifecycle from strategy through execution, and provide financial analysis to optimize network performance and value-based care.

You will collaborate with Finance, Legal, Compliance, Provider Operations, and Clinical leadership to implement agreements, assess reimbursement scenarios, monitor market conditions, and strengthen provider partnerships while