Strategic Provider Partnerships Lead

VNS Health; New York (NY); On-site; USD 85,000 - 106,000; Full time

Benefits offered by this job

Referral bonus opportunities

30 days PTO + 9 holidays

Health insurance for you and family

Employer-matched retirement

Tuition reimbursement

FSAs for healthcare and dependent care

Professional growth opportunities

Internal mobility and advancement

Job summary

VNS Health in New York is seeking an experienced provider relations and contracting leader to manage an assigned provider portfolio. You will recruit providers, negotiate complex reimbursement terms, and coordinate contract implementations while working with internal teams to improve access and performance.

The role emphasizes strategic account management, data-driven decision making, and collaboration with clinical, financial, and operations groups to support Stars, HEDIS, and risk adjustment

Qualifications

• Bachelor's degree or the equivalent relevant work experience required.
• Minimum five years of progressive experience in provider contracting, provider relations, network management, healthcare finance or a related field.
• Knowledge of provider reimbursement, fee schedules and performance incentives; strong negotiation and relationship management skills.
• Proficiency in Excel-based analysis and provider data systems; familiarity with Stars/HEDIS and risk adjustment.

Responsibilities

• Owns provider relationships and account plans for an assigned portfolio, serving as the primary contact and setting priorities for service, contracting, recruitment, access and performance improvement.
• Negotiates provider agreements, renewals and amendments in complex reimbursement environments using market, claims and financial information.
• Assesses network needs and recruits providers to address gaps and improve member access.
• Leads resolution of provider service, reimbursement, contract and operational issues with cross-functional teams.
• Coordinates contract implementation across credentialing, provider data, contract administration and claims teams; manages renewals and terminations.
• Leads provider business reviews and Joint Operating Committee meetings to drive actions and close performance gaps.
• Partners to improve Stars, HEDIS and risk adjustment and incorporate priorities into plans and reviews.
• Leads value-based and quality-incentive arrangements within authority and coordinates data exchange and reporting.

Skills

Provider contracting

Provider relations

Network management

Healthcare finance

Excel analysis

Education

Bachelor's degree

Tools

Contract lifecycle management tools

Job description

VNS Health in New York is seeking an experienced provider relations and contracting leader to manage an assigned provider portfolio. You will recruit providers, negotiate complex reimbursement terms, and coordinate contract implementations while working with internal teams to improve access and performance.

The role emphasizes strategic account management, data-driven decision making, and collaboration with clinical, financial, and operations groups to support Stars, HEDIS, and risk adjustment