Summary
Join our Provider Services team in a highly visible role focused on expanding and strengthening a Medicare-compliant provider network. As a Senior Network Development Contractor, you will combine provider contracting expertise with proactive business development to maintain network adequacy, support expansion into new counties, and build productive relationships with physician groups, hospitals, ancillary providers, and other complex healthcare organizations.
This is an opportunity for a self-directed professional who enjoys researching new markets, initiating provider outreach, communicating the value of network participation, and guiding prospects through negotiation and execution. You will join a collaborative, fully remote contracting team that supports employees across multiple time zones and values sound judgment, organization, and the ability to adapt to changing business priorities. Internal Job Title : Provider Contractor Senior
Why Join Us:
- Make a direct impact on access to care by building networks that support Medicare beneficiaries in new and existing markets.
- Own meaningful provider relationships from initial research and outreach through negotiation and contract execution.
- Work with a collaborative, fully remote team serving multiple time zones.
- Take on varied assignments that reward initiative, sound judgment, and independent decision-making.
What Success Looks Like:
- Achievement of network adequacy and contracting goals.
- Consistent execution of provider outreach and recruitment activities.
- Quality and timeliness of contract negotiations and implementations.
- Effective prioritization of opportunities resulting in measurable network expansion.
- Demonstrated critical thinking and sound business judgment in provider selection and contracting decisions.
Work Schedule: The ideal work hours for this position are 8:00 a.m. to 5:00 p.m. Central Time, with some flexibility based on the candidate's location.
Essential Duties & Responsibilities
- Recruit, evaluate, contract with, and maintain physician, hospital, ancillary, and other provider relationships within assigned geographies.
- Help maintain network adequacy while supporting strategic expansion into new counties and markets.
- Research prospective providers, conduct due diligence, and independently prioritize outreach based on evolving network needs.
- Build relationships through cold calling, email outreach, and consultative conversations that clearly communicate the value of joining the network.
- Initiate, negotiate, and execute managed care contracts, including agreements involving complex providers and large medical groups.
- Explain contract terms, payment structures, and reimbursement rates to providers and assess the financial impact of proposed terms.
- Maintain accurate contracts, outreach activity, and supporting documentation within established tracking systems.
- Apply sound judgment in ambiguous situations while aligning decisions with department strategy, organizational objectives, established guidelines, and procedures.
- Manage multiple priorities in a fast-paced, remote environment and contribute to continuous process improvement.
Qualifications
- Bachelor's degree in business, healthcare administration, or a related field, or equivalent relevant experience.
- 4-8 years of experience negotiating and servicing managed care contracts with physicians, hospitals, ancillary providers, and/or other healthcare providers.
- Experience with Medicare Advantage contracting; familiarity with Medicare Special Needs Plans, including I-SNP and C-SNP, is a plus.
- Experience in value-based contracting and/or a strong understanding of value-based care concepts.
- A track record of working with complex providers, such as large institutional providers, large medical groups, and ancillary organizations.
- Strong provider outreach, prospecting, relationship-building, research, and due diligence capabilities.
- Confidence initiating cold calls and email outreach and presenting a compelling case for network participation.
- Ability to understand and communicate contract terms, reimbursement structures, payment methodologies, and financial impact.
- Excellent written and verbal communication, organization, documentation, and record-keeping skills.
- Ability to work independently, make informed decisions with minimal direction, and balance multiple priorities as business needs change.
- Proficiency with Microsoft Word and Excel.
Position Type: Full-Time
Category: Network Management