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Network Strategy Director(Preferred Experience In Managed Care)

Role overview

Qualifications

  • Bachelor's degree in business related field required
  • Eight (8) years provider contracting experience
  • Direct experience negotiating with major health systems or IDNs preferred
  • Experience designing value-based or risk-based contract structures preferred

Responsibilities

  • Lead negotiation of CareSource's largest and most strategically significant provider agreements
  • Serve as the enterprise SME on contracting strategy and reimbursement methodology
  • Design and pilot novel contract structures ahead of broader rollout
  • Mentor contracting professionals enterprise-wide on negotiation techniques

Key facts

  • Remote from: United States
  • Full time
  • Expert & Leadership (>10 years)
  • Strategy Director
  • $113K – $198K / year
  • English

Hard skills

Other skills

  • Negotiation
  • Mentorship
  • Strategic Planning
  • Executive Presence
  • Collaboration

About the company

CareSource logo

CareSource

  • Health Insurance & Payers
  • Large
  • 1,001–5,000
Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits. CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve. CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf Si usted o alguien a quien ayuda tienen preguntas sobre CareSource, tiene derecho a recibir esta información y ayuda en su propio idioma sin costo. Para hablar con un intérprete, Por favor, llame al número de Servicios para Afiliados que figura en su tarjeta de identificación. 如果您或者您在帮助的人对 CareSource 存有疑问,您有权 免费获得以您的语言提供的帮助和信息。 如果您需要与一 位翻译交谈,请拨打您的会员 ID 卡上的会员服务电话号码。

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Job description

Job Summary:

The Network Strategy Director serves as the enterprise subject-matter expert for provider contracting, leading the organization's most complex, high-risk negotiations and strategic contracting initiatives. They provide senior-level expertise, establish contracting standards and best practices, and mentor contracting professionals across the organization.

Essential Functions:
  • Lead negotiation of CareSource's largest and most strategically significant provider agreements — major health systems, multi-market IDNs, and national/DME vendor contracts — often representing eight-figure annual spend.
  • Serve as the enterprise SME on contracting strategy, reimbursement methodology, and deal structuring; advise leadership on negotiation approach for the highest-stakes deals.
  • Design and pilot novel contract structures (advanced VBC arrangements, risk corridors, performance-based rate mechanisms) ahead of broader rollout.
  • Mentor contracting professionals enterprise-wide on negotiation techniques, deal structuring, and complex contracting methodologies.
  • Partner cross-functionally to resolve complex contractual, financial, and regulatory issues arising during negotiations.
  • Represent National Network Development in executive-level provider discussions and market-facing negotiations requiring senior credibility.
  • Own strategic renewal planning for the highest-exposure agreements in the renewal pipeline (90/180/365-day windows).
  • Contribute contracting expertise to enterprise initiatives — new market entry readiness, network optimization pilots, VBC expansion strategy.
  • Perform any other job related duties as requested.

Education and Experience:
  • Bachelor's degree in business related field required
  • Master's degree is preferred
  • Equivalent years of relevant work experience may be accepted in lieu of required education
  • Eight (8) years provider contracting experience, including a demonstrated track record leading complex, high-dollar, multi-stakeholder negotiations independently required
  • Direct experience negotiating with major health systems or IDNs preferred
  • Experience designing value-based or risk-based contract structures preferred
Competencies, Knowledge and Skills:
  • 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
Licensure and Certification:
  • None
Working Conditions:
  • General office environment; may be required to sit or stand for extended periods of time
  • Up to 15% (occasional) travel to attend meetings, trainings, and conferences may be required

Compensation Range:

$113,000.00 - $197,700.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Fostering a Collaborative Workplace Culture

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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