Director of Network Relations

Role Summary

The Director of Network Relations leads the Company's provider network function across all fully insured commercial health plan markets — owning network strategy, adequacy compliance, and complex contract negotiation, including value-based arrangement design that aligns provider incentives with quality and cost outcomes.

Responsibilities

• Network Strategy Development & Execution : Develops and continuously refines the Company's provider network strategy — geographic prioritization, contracting targets, payment methodology, and network composition objectives.
• Team Leadership & Territory Oversight: Leads, coaches, develops, and performance-manages the Network Relations team, setting territory objectives and providing strategic guidance on complex contracting situations.
• Complex Contract Negotiation & Value-Based Design: Personally leads high-value, strategically significant provider contract negotiations and designs innovative value-based contracting models that align provider incentives with quality outcomes.
• Network Adequacy Oversight & Regulatory Compliance: Maintains executive-level oversight of network adequacy monitoring and regulatory filing activity, serving as the company's primary point of accountability to regulators on adequacy matters.
• Fee Schedule Governance & Leadership Reporting: Partners with Actuarial on fee schedule benchmarks and rate targets and delivers regular network performance reports to the executive team.

Qualifications

Required

• Bachelor's degree in Business, Healthcare Administration, Economics, or related field
• 10+ years in managed care contracting, provider network development, or provider relations
• 3+ years in a director-level role managing a network contracting team
• Expertise negotiating multi-methodology contracts, including value-based and risk arrangements, and adequacy compliance

Preferred

• MBA, Healthcare Administration, or closely related graduate degree
• Experience building a network function from inception at a growth-stage health plan
• Experience in both health plan-side and provider-side contracting roles
• Familiarity with state-level commercial health insurance market and adequacy requirements