AVP – Provider Strategy, Contracting

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🇺🇸 United States – Remote

💵 $180k - $225k / year

⏰ Full Time

🔴 Lead

👔 Vice President

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CareCentrix

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1996

⚕️ Healthcare Insurance

💊 Pharmaceuticals

💰 Private Equity Round on 2011-09

Healthcare Insurance • Healthcare • Pharmaceuticals

CareCentrix is a healthcare company that simplifies care coordination and home benefit management, enabling health at home for members. By focusing on personalized care and utilizing their proprietary HomeBridge platform, they identify and engage members transitioning from hospital to home, ensuring timely delivery of appropriate services. CareCentrix's whole-person approach aims to improve outcomes, lower costs, and enhance both member and provider satisfaction through a high-quality provider network and data-driven analytics.

📋 Description

• Lead the development and execution of enterprise-wide provider network and contacting strategies to ensure network adequacy, competitive positioning, and alignment with business growth objectives • Define and drive multi-year provider contracting roadmaps, including rate strategy, value-based care models, and risk-sharing arrangements • Oversee network design, expansion, and optimization across markets, ensuring alignment to cost-of-care targets, access standards, and product strategy • Utilize market intelligence, competitive insights, and performance analytics to inform network composition and contracting priorities • Ensure network configurations balance cost efficiency, quality outcomes, and provider access including optimization of high performing and preferred provider tiers • Direct end-to-end provider network development, including contracting strategy, negotiation execution, reimbursement methodologies, and ongoing performance management • Establish and implement innovative contracting models (e.g. value-based care, bundled payments, shared savings, capitation where appropriate) to drive cost, quality, and experience outcomes • Lead complex provider negotiations with health systems, specialty providers, and ancillary partners, ensuring alignment with financial targets and strategic priorities • Identify and executive opportunities to strengthen network performance through contract optimization, utilization management alignment, and provider incentives • Oversee network capacity planning, coverage adequacy, and provider mix optimization to meet demand and growth projections • Drive enhancements to provider-facing tools, systems, and processes to improve operational efficiency and experience • Ensure all network initiatives and contracting programs delivery against defined KPIs, including affordability, unit cost reductions, ROI and performance guarantees • Partner with Product, Clinical, and Market leaders to align network capabilities with product design and clinical program requirements • Ensure provider contracts and reimbursement structures support new product features, care models and clinical program requirements • Enable scalable network and contracting solutions to support new market entry, product launches, and client-specific configurations • Lead the development of network-related program capabilities and positioning to support client growth and retention • Partner closely Sales, Underwriting, Medical Economics, and Actuarial teams to align network contracting strategy with pricing, underwriting assumptions and growth targets • Support pre-sale and post-sale activities through network strategy articulation, provider disruption analysis, and competitive positioning • Ensure timely adaptation of network models in response to evolving healthcare landscape and client needs • Serve as a key liaison between Network Management, Product / Network Analytics, Medical Economics, Provider Experience, Clinical Operations, Compliance, Revenue Cycle Management (RCM), Implementations and Operations teams • Align stakeholders around contracting strategies, financial targets, and execution plans, ensuring seamless operationalization • Provide strategic input into enterprise priorities, including cost-of-care management, provider partnerships, and long-term growth strategy • Represent CareCentrix in executive-level negotiations with provider organizations, health systems and strategic partners • Build and maintain strong, collaborative provider relationships that enable favorable contracting outcomes and long-term partnership value

🎯 Requirements

• Bachelor’s degree required; Master’s or MBA strongly preferred • 8–12+ years of experience in healthcare, with significant focus on provider network development, contract negotiations operations, provider credentialing, provider communications/engagement and strategy • Demonstrated experience building and managing provider networks, including network adequacy and market expansion • Experience leading cross-functional initiatives and influencing senior stakeholders • Strong understanding of healthcare delivery models, ideally within home health or post-acute care • Proven ability to drive operational improvements, manage complex programs, and lead high-performing teams • Strategic thinking with strong execution orientation • Data-driven decision-making and analytical capability • Excellent communication and stakeholder management skills • Ability to lead through change and ambiguity • Strong problem-solving and organizational leadership skills

🏖️ Benefits

• Medical • Dental • Vision • 401(k) with company match • HSA employer contributions • Dependent Care FSA employer contribution • Paid Time Off • Personal/Sick Time • Paid Parental Leave • corporate bonus incentive