About the role
- Build and maintain a robust, competitive, compliant, and accessible provider network across current and expansion service areas
- Oversee a team of network development specialists
- Develop and implement network expansion strategies aligned with access standards and regional adequacy goals
- Monitor and report on network adequacy and provider participation
- Lead and manage a team to execute contracting and network development initiatives
- Negotiate provider agreements with independent physicians, and other ancillary partners
- Partner with internal areas to streamline provider onboarding
- Collaborate with internal stakeholders to support growth strategies and expansion
- Support annual readiness reviews, corrective action plans, audits, and RFP-related network development tasks
- Foster strong provider relationships that support collaborative care
Requirements
- Bachelor’s degree and/or master’s in healthcare administration, public health, or related field preferred
- Minimum 5-7 years of experience in provider contracting, network development, or managed care required
- At least 2 years of supervisory or team lead experience, with demonstrated ability to coach and manage staff
- Deep understanding of Pennsylvania’s Medicaid, Medicare and/or Exchange requirements and provider landscape
- Proven track record of successful provider negotiations, network adequacy analysis, and regulatory compliance
- Strong organizational, interpersonal, and communication skills
- Proficiency in provider database systems, Microsoft Office Suite, and regulatory reporting platforms
- Familiarity with value-based care or alternative payment models within Medicaid preferred
- medical (including prescription) insurance
- supplemental insurance
- dental insurance
- vision insurance
- life and AD&D insurance
- short- and long-term disability
- flexible spending accounts
- retirement plans
- tuition assistance
- access to tuition discounts at Thomas Jefferson University
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
provider contractingnetwork developmentnetwork adequacy analysisregulatory complianceprovider negotiationsvalue-based carealternative payment models
Soft skills
organizational skillsinterpersonal skillscommunication skillscoachingteam management
Certifications
Bachelor’s degreeMaster’s degree in healthcare administrationMaster’s degree in public health