Director, Network Development – Mid Atlantic Region

This is a fully remote position, open to applicants in North Carolina, +2 more states.

📋 Description

• Oversees contract negotiations with Major Health Systems, large physician groups, and ancillary providers; managing multiple negotiations concurrently to fulfill growth objectives.

• Possesses in-depth knowledge and experience across all clinical specialties to ensure that contract terms and conditions effectively address the coding structures most affected by negotiations.

• Actively cultivates relationships that support provider partnerships, aligning with the local market strategy.

• Initiates, maintains, and fosters effective communication channels with matrix partners including, but not limited to, Claims, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales, and Marketing.

• Accountable for achieving unit cost targets while maintaining a sufficient network to secure and uphold a competitive position.

• Identifies and manages initiatives aimed at improving overall medical costs and quality, including the renegotiation of existing agreements.

• Prepares, analyzes, reviews, and projects the financial implications of high-spend or increasingly complex provider contracts and alternative contract terms.

• Collaborates cross-functionally to oversee provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports related to negotiation and reimbursement modeling activities.

• Aids in resolving elevated provider service complaints by researching and negotiating with internal and external partners/customers to address complex or escalated issues.

• Manages key provider relationships and is responsible for crucial interactions with providers and business staff.

• Mentors and supports newer team members on strategies and techniques for successful negotiations.

• Exhibits comprehensive knowledge of providers within a designated geographic area, including an understanding of interrelationships and the competitive landscape.

• Collaborates with Regulatory Affairs to ensure timely and accurate network filings, participating with Compliance to ensure adherence to established guidelines supporting Mental Health Parity.

• This role encompasses additional duties as assigned.

⛳️ Requirements

• Exceptional problem-solving, decision-making, and negotiating skills, along with proficiency in contract language and financial acumen.

• Experience with complex hospital/health systems, large physician groups, and ancillary provider contracting and negotiations.

• Background in negotiating delegated credentialing agreements.

• Proven experience in developing and managing key provider relationships, including senior executives.

• Demonstrated capability in seeking, building, and nurturing robust external relationships with provider partners.

• In-depth understanding and experience with larger, complex integrated delivery systems, managed care, and provider business models.

• Team-oriented individual with a track record of establishing strong working relationships within a fast-paced environment.

• Ability to influence both sales and provider audiences through excellent written and verbal communication skills, including experience with formal presentations.

• Strong customer-centric and interpersonal skills are essential.

🏝️ Benefits

• Curative Health Plan (100% employer-covered medical premiums for you and 50% coverage for dependents on the base plan.)

• $0 copays and $0 deductibles (upon completion of our Baseline Visit)

• Preventive and primary care included.

• Mental health support (Rula, Televero, Two Chairs, Recovery Unplugged).

• One-on-one care navigation.

• Chronic condition programs (diabetes, weight, hypertension).

• Maternity and family planning assistance.

• 24/7/365 Curative Telehealth.

• Pharmacy benefits.

• Comprehensive dental and vision coverage.

• Employer-provided life and disability coverage with additional supplemental options.

• Flexible spending accounts.

• Flexible work options: remote and in-person opportunities.

• Generous PTO policy plus 11 paid annual company holidays.

• 401K available for full-time employees.

• Generous parental leave of up to 8–12 weeks, depending on role eligibility.