Strategic Provider Network Negotiator - In-Network Growth

Healthfirst; Layton (UT); On-site; USD 105,000 - 160,000; Full time

Job summary

Healthfirst seeks a Senior Provider Network Contractor to strategically engage out-of-network providers and secure in-network participation at market-aligned rates. The role emphasizes high-impact negotiations to reduce out-of-network spend and improve network adequacy.

The contractor will lead complex negotiations, leverage benchmarking data, and partner with Finance, Legal, and Operations to align with enterprise objectives. Strong communication and autonomy are essential for success.

Qualifications

• Bachelor's degree required with 8+ years in managed care contracting or network negotiations.
• Proven track record leading complex provider negotiations and securing in-network agreements.
• Deep knowledge of reimbursement models, provider economics, and regulatory frameworks.
• Strong ability to navigate provider market dynamics and leverage strategies.

Responsibilities

• Identify and prioritize high-cost out-of-network providers based on data and regulatory requirements.
• Lead complex negotiations to achieve favorable rates and contract terms.
• Collaborate with Finance, Legal, Utilization Management and Operations for alignment.
• Track outcomes and provide executive-level reporting on progress and financial impact.

Skills

Out-of-network negotiations

Provider engagement

Contract negotiation

Market benchmarking

Executive communication

Education

Bachelor's degree

Job description

Healthfirst seeks a Senior Provider Network Contractor to strategically engage out-of-network providers and secure in-network participation at market-aligned rates. The role emphasizes high-impact negotiations to reduce out-of-network spend and improve network adequacy.

The contractor will lead complex negotiations, leverage benchmarking data, and partner with Finance, Legal, and Operations to align with enterprise objectives. Strong communication and autonomy are essential for success.