Overview:
The AVP, Provider Strategy and Contracting is a strategic leadership role responsible for overseeing the development, negotiation, execution, and ongoing management of provider contracts across CareCentrix’s network.
This role leads provider partnerships, contracting strategy, rate negotiations, adequacy, and performance optimization to support multiple product lines, including durable medical equipment, home infusion therapy, sleep management, and traditional home health.
In this role you will develop and implement scalable contracting models and network strategies to build high-performing provider networks. This includes oversight of contract lifecycle management, negotiation frameworks, provider rate setting, and value-based or performance-driven arrangements where applicable. The role partners cross-functionally to enhance network capabilities, ensure adequate provider coverage to meet patient needs, strengthen provider engagement, and drive operational excellence across the provider lifecycle—from contracting and onboarding through performance management and renewal.
You will partner cross-functionally to enhance network capabilities, ensure adequate provider coverage to meet patient needs, strengthen provider engagement, and drive operational excellence across the provider lifecycle—from contracting and onboarding through performance management and renewal.
Responsibilities:
Network Strategy & Adequacy
- 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
Provider Network Development, Contracting & Operations
- 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
Program Product & Contracting Alignment
- 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
Pipeline, Growth & Innovation
- 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
Cross-Functional Leadership
- 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
External Engagement & Provider Partnerships
- 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
Qualifications:
- 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
What We Offer:
What We Offer:
- Pay Range: $180000 – $226000 / (year) plus corporate bonus incentive. The pay range included in this posting reflects future growth / earning potential.
- 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, and more.
- Award winning culture: Keeps our company values at the heart of everything we do: We Care; We Do the Right Thing; We Strive for Excellence; We Think BIG; We Take our Work Seriously, Not Ourselves.
#IDCC
CareCentrix maintains a drug-free workplace.
We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.
CareCentrix accepts applications on an ongoing basis until a candidate is identified.
