Senior Director, Network Strategy

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

📋 Description

• Develop and spearhead enterprise network strategies across both established and emerging markets.

• Aid in market expansion initiatives by crafting strategies that align with growth objectives and local market dynamics.

• Evaluate and oversee network adequacy, ensuring timely access to high-quality providers, specialists, hospitals, and ancillary services.

• Identify gaps in the network, access challenges, and specific market needs while formulating strategies to address them.

• Keep abreast of industry trends, regulatory requirements, and competitive market landscapes.

• Lead, mentor, and cultivate a high-performing team of network strategy and contracting professionals.

• Provide strategic direction and operational support to regional and field-based team members.

• Promote collaboration among Finance, Analytics, Operations, clinical leadership, Compliance, and growth teams.

• Conduct outreach and complex negotiations with hospitals, health systems, large physician groups, and strategic provider partners.

• Investigate innovative contracting methods linked to participant access, care coordination, medical record retrieval, quality performance, and operational responsiveness.

⛳️ Requirements

• Candidates MUST be located and residing in the State of California.

• A Bachelor’s degree is required; an advanced degree is preferred.

• A minimum of ten (10) years of experience in provider network strategy and managed care contracting.

• Proven experience leading negotiations with hospitals, health systems, and large provider organizations.

• Strong understanding of network adequacy standards, provider operations, reimbursement methodologies, and value-based care models.

• Demonstrated success in building provider networks across various markets or regions, particularly in California.

• Experience in Medicare, Medicaid, managed care, PACE, or value-based care settings.

• At least two (2) years of supervisory experience with a proven ability to mentor and develop team members.

• Strong leadership background managing high-performing teams in a matrixed organization.

• Proof of vaccination, or a vaccine declination form, is required prior to employment.

🏝️ Benefits

• Medical insurance coverage (Medical, Dental, Vision).

• 17 days of personal time off (PTO).

• 12 holidays observed annually.

• 6 sick days.

• 401K savings with matching contributions.

• Comprehensive compensation package including base salary and bonuses.

• Additional benefits.

• COVID-19 vaccination policy and infection control/PPE standards.