Network Strategy Director – Preferred Experience In Managed Care

Job not on LinkedIn

🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $113k - $197.7k / year

⏰ Full Time

🔴 Lead

🧐 Strategy

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Lead negotiation of CareSource's largest and most strategically significant provider agreements, including major health systems, multi-market IDNs, and national/DME vendor contracts • Serve as the enterprise subject-matter expert on contracting strategy, reimbursement methodology, and deal structuring • Advise leadership on negotiation approaches for high-stakes deals • Design and pilot novel contract structures, including advanced VBC arrangements, risk corridors, and performance-based rate mechanisms • Mentor contracting professionals enterprise-wide • Partner cross-functionally to resolve complex contractual, financial, and regulatory issues • Represent National Network Development in executive-level provider discussions and market-facing negotiations • Own strategic renewal planning for highest-exposure agreements using 90/180/365-day windows • Contribute contracting expertise to enterprise initiatives such as new market entry readiness, network optimization pilots, and VBC expansion strategy • Perform other job-related duties as requested

🎯 Requirements

• Bachelor's degree in a business-related field required • Equivalent years of relevant work experience may be accepted in lieu of required education • Eight (8) years of provider contracting experience required • Demonstrated track record leading complex, high-dollar, multi-stakeholder negotiations independently • Direct experience negotiating with major health systems or IDNs preferred • Experience designing value-based or risk-based contract structures preferred • Expert-level knowledge of reimbursement methodology and contract law fundamentals • Ability to design and defend novel contract structures • Sophisticated financial and risk analysis • Expert-level negotiation and deal architecture • Enterprise strategic thinking • Executive presence and provider-facing credibility • Mentorship and technical leadership without formal authority • Complex risk and financial structuring • Up to 15% occasional travel may be required

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Comprehensive total rewards package • Employee total well-being support

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