Manager of Network Contracting Team

We are seeking an experienced Manager of Network Contracting to lead the development and optimization of a high-performing provider network supporting the U.S. Department of Veterans Affairs Community Care Network (CCN) program.

In this leadership role, you will oversee a team responsible for building and managing relationships with physicians, hospitals, pharmacies, and ancillary providers to ensure a strong, geographically competitive network that delivers high-quality care for Veterans while maintaining financial sustainability.

This role is ideal for professionals with healthcare payer network contracting experience, strong provider negotiation skills, and leadership experience managing contracting teams.

What You'll DoNetwork Strategy & Development

• Lead the development and optimization of a broad, accessible provider network, including hospitals, physicians, pharmacies, and ancillary providers.
• Ensure network composition meets geographic access and specialty distribution requirements for the VA CCN program.
• Evaluate network performance and implement strategies to improve cost efficiency, access, and provider participation.
• Monitor industry trends and recommend improvements to network strategy.

Provider Contracting & Negotiations

• Oversee and participate in provider contract negotiations, ensuring compliance with company contract templates and reimbursement structures.
• Evaluate provider rates, utilization patterns, referral activity, and performance metrics to guide negotiation strategy.
• Identify opportunities for cost savings, contract remediation, and network optimization.
• Communicate proposed contract terms and negotiate mutually beneficial agreements with providers.
• Assess financial and operational implications of contract language and requested changes.

Leadership & Team Development

• Provide oversight and guidance to a team of Network Provider Contract Managers.
• Support team development through training, mentorship, and performance feedback.
• Ensure contracting activities align with program goals, timelines, and compliance standards.
• Educate team members on provider termination processes and negotiation strategies.

Project & Program Management

• Develop and manage detailed project plans related to network development initiatives.
• Coordinate with cross-functional teams to identify resource needs and ensure project success.
• Track project milestones and provide progress updates throughout the project lifecycle.
• Align scheduling and resource allocation with project scope, objectives, and potential risks.

Financial & Data Analysis

• Evaluate provider contracts and network performance to identify cost-saving opportunities and financial improvements.
• Partner with analytics and pricing teams to evaluate payment methodologies and financial modeling.
• Utilize healthcare reimbursement methodologies such as RBRVS, DRGs, and ASC groupers to inform rate negotiations.
• Ensure compliance with organizational contract policies and contracting standards.

Stakeholder Engagement

• Represent the network contracting department in internal and external meetings with healthcare providers and stakeholders.
• Provide updates and insights from provider negotiations and network performance to leadership and business partners.
• Build and maintain strong relationships with providers and internal teams to support network growth and stability.

• 5+ years of healthcare network management or provider contracting experience
• 3+ years of direct provider contracting experience (facility, physician, and ancillary providers)
• 3+ years of leadership or supervisory experience
• Experience managing complex provider negotiations and contract strategy
• Experience contributing to product pricing, financial modeling, and medical cost management
• Strong knowledge of healthcare reimbursement methodologies including:
• Medicare RBRVS
• DRGs
• Ambulatory Surgery Center (ASC) Groupers
• Ability to analyze financial and operational data to guide network strategy
• Bachelor's degree or equivalent professional experience, * Do you have In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc. ?, * Supervising: 3 years (Required)
• Direct provider contracting: 3 years (Required)
• development of product pricing : 2 years (Required)
• utilizing financial modeling in making rate decisions : 2 years (Required)
• managing a medical cost and administrative budget: 2 years (Required)
• Network Management-related role: 5 years (Required)

$62 - $65 an hour - Full-time, Contract, Pulled from the full job description

• Health insurance
• Vision insurance
• Dental insurance, * Dental insurance
• Health insurance
• Vision insurance