Senior Network Development Contractor

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

📋 Description

• Recruit, assess, engage, and sustain relationships with physicians, hospitals, ancillary providers, and other partners within designated regions.

• Assist in ensuring network adequacy while facilitating strategic growth into new counties and markets.

• Investigate potential providers, perform due diligence, and independently prioritize outreach based on changing network requirements.

• Foster relationships through cold calling, email communications, and consultative discussions that convey the benefits of joining the network.

• Initiate, negotiate, and finalize managed care contracts, including those involving complex providers and large medical groups.

• Clarify contract terms, payment structures, and reimbursement rates to providers, assessing the financial implications of proposed terms.

• Maintain precise contracts, outreach activities, and relevant documentation within established tracking systems.

• Exercise sound judgment in ambiguous situations while ensuring decisions align with departmental strategies, organizational goals, guidelines, and procedures.

• Manage multiple priorities in a dynamic, remote environment and contribute to ongoing process improvements.

⛳️ Requirements

• A Bachelor’s degree in business, healthcare administration, or a related field, or equivalent relevant experience.

• 4–8 years of experience in negotiating and managing managed care contracts with physicians, hospitals, ancillary providers, and/or other healthcare professionals.

• Familiarity with Medicare Advantage contracting.

• Knowledge of Medicare Special Needs Plans, including I-SNP and C-SNP, is advantageous.

• Experience in value-based contracting and/or a solid understanding of value-based care concepts.

• Proven track record of engaging with complex providers, such as large institutional providers, extensive medical groups, and ancillary organizations.

• Strong skills in provider outreach, prospecting, relationship-building, research, and due diligence.

• Confidence in initiating cold calls and email outreach and effectively presenting a compelling case for network participation.

• Ability to comprehend and communicate contract terms, reimbursement structures, payment methodologies, and financial impact.

• Exceptional written and verbal communication, organizational, documentation, and record-keeping skills.

• Capability to work independently, make well-informed decisions with minimal supervision, and manage multiple priorities as business needs evolve.

• Proficiency in Microsoft Word and Excel.

• Must be eligible to work without visa sponsorship; the company is unable to provide visa sponsorship.

🏝️ Benefits

• Fully remote work arrangement.

• Flexible working hours based on the candidate's location.

• Opportunity to directly impact access to care for Medicare beneficiaries.

• Collaborative team environment.

• Diverse assignments that reward initiative, sound judgment, and independent decision-making.