Director, Provider Contracting

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Gravie

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2013

🏥 Healthcare

🛡️ Insurance

🤝 B2B

💰 $150M Private Equity Round - Gravie on 2025-05

Healthcare • Insurance • B2B

Gravie is a benefits and health insurance solutions company that helps small and midsize employers, brokers, and employees access and administer more flexible, affordable health benefits. Its flagship offerings include Comfort (a level-funded health plan), Gravie ICHRA (Individual Coverage Health Reimbursement Arrangement administration), Gravie Pay (support for healthcare costs), and Gravie Care; the company focuses on enabling SMBs to offer individualized, lower-cost coverage and simplifying benefits administration.

📋 Description

• Own the provider contracting strategy for Gravie's health plan • Lead value-based care contracting and negotiate complex network agreements • Manage provider overpayment recoupment, including outreach, resolution, Claims coordination, and Finance recovery tracking • Oversee delegated entities, including audits and corrective action plans • Serve as the network team's product and technology lead with Product and Engineering • Own new provider network contracts and launches in new markets • Ensure contracts and network operations comply with CMS, state DOI, and network adequacy requirements • Partner with Finance and Actuarial on reimbursement strategy • Analyze network adequacy and market dynamics for expansion opportunities • Serve as senior escalation point for provider and vendor contract disputes • Track industry trends and competitor positioning • Partner with executive leadership on network strategy, budgeting, and cost containment

🎯 Requirements

• Bachelor's degree, or equivalent experience • 8+ years of experience in provider contracting, network management, or healthcare reimbursement • 5+ years of experience negotiating value-based care arrangements, including risk-based and shared savings models • 5+ years of experience independently drafting and negotiating complex healthcare contracts and delegation agreements • 5+ years of experience leading network contracting strategy and managing provider, facility, or vendor relationships • 3+ years of experience managing delegated entities, including delegate oversight, audits, and compliance • 4+ years of experience ensuring contracts and network operations comply with CMS and state insurance regulations • 2+ years of experience partnering with Product or Engineering teams to shape systems or tooling requirements • Proven track record leading new network builds or market launches from contracting through go-live • Experience launching provider networks in new geographies or markets • Experience at a small or mid-sized health plan • Familiarity with contracting or network configuration systems • Previous startup company experience • Project or program management experience • Currently authorized to work in the United States • Must answer whether employer visa sponsorship is required

🏖️ Benefits

• Alternative medicine coverage • Flexible PTO • Up to 16 weeks paid parental leave • Paid holidays • 401k program • Transportation perks • Education reimbursement • 2 days of paid paw-ternity leave • Equity • Bonus