Network Strategy Director – Preferred Experience in Managed Care

This is a fully remote position, open to applicants in United States.

📋 Description

• Lead the negotiation of CareSource's most significant provider agreements, particularly with major health systems, multi-market IDNs, and national/DME vendor contracts.

• Act as the enterprise expert on contracting strategies, reimbursement methodologies, and deal structuring.

• Provide guidance to leadership on negotiation strategies for high-stakes deals.

• Develop and pilot innovative contract structures, such as advanced VBC arrangements, risk corridors, and performance-based rate mechanisms.

• Mentor contracting professionals across the enterprise on negotiation techniques, deal structuring, and intricate contracting methodologies.

• Collaborate across functions to address complex contractual, financial, and regulatory issues.

• Represent National Network Development in executive-level discussions with providers and in market-facing negotiations.

• Manage strategic renewal planning for high-exposure agreements within 90/180/365-day renewal windows.

• Provide contracting expertise for new market entry readiness, network optimization initiatives, and VBC expansion strategies.

• Carry out additional job-related duties as assigned.

⛳️ Requirements

• A bachelor's degree in a business-related field is required, or an equivalent number of years of relevant work experience may be accepted in place of the educational requirement.

• A minimum of eight (8) years of experience in provider contracting is required.

• Proven experience leading complex, high-value negotiations with multiple stakeholders independently.

• Direct experience negotiating with major health systems or IDNs is preferred.

• Experience in designing value-based or risk-based contract structures is preferred.

• Advanced knowledge of reimbursement methodologies and fundamental contract law is essential.

• Capability to design and justify innovative contract structures.

• Proficient in sophisticated financial and risk analysis.

• Expert-level skills in negotiation and deal architecture.

• Strong strategic thinking at the enterprise level.

• Possess executive presence and credibility in provider-facing situations.

• Ability to mentor and provide technical leadership without formal authority.

• Experience with complex risk and financial structuring is required.

• Occasional travel of up to 15% may be necessary.

🏝️ Benefits

• A bonus linked to company and individual performance may be available.

• A substantial and comprehensive total rewards package is offered.

• Total well-being support is provided.