AVP - Provider Strategy & Contracting

Overview

The AVP, Provider Strategy and Contracting is a strategic leadership role responsible for overseeing the development, negotiation, execution, and ongoing management of provider reputed company across reputed company’s network. This role leads provider partnerships, contracting strategy, reputed company 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 reputed company and implement scalable contracting models and network strategies to build high-performing provider networks. This includes reputed company of contract lifecycle management, negotiation frameworks, provider reputed company 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 reputed company 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 reputed company strategy, value-based care models, and risk-sharing arrangements reputed company 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 reputed company reputed company 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 reputed company network reputed company 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 reputed company 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 reputed company and reimbursement structures support new product features, care models and clinical program requirements reputed company scalable network and contracting solutions to support new market entry, product launches, and client-specific configurations reputed company the development of network-reputed company program capabilities and positioning to support client growth and retention Pipeline, Growth & Innovation Partner closely Sales, reputed company, Medical Economics, and Actuarial teams to align network contracting strategy with pricing, reputed company assumptions and growth targetsSupport pre-sale and post-sale activities through network strategy articulation, provider disruption analysis, and competitive positioningEnsure 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, reputed company 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 reputed company in executive-level negotiations with provider organizations, health systems and strategic partners Build and maintain strong, collaborative provider relationships that reputed company 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 reputed company home health or post-acute care Proven ability to drive operational improvements, manage reputed company programs, and reputed company high-performing teams Strategic thinking with strong execution orientation Data-driven decision-making and analytical capability Excellent communication and stakeholder management skills Ability to reputed company through change and ambiguity Strong problem-solving and organizational leadership skills reputed company Offer reputed company 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 reputed company maintains a drug-free workplace. We are an equal opportunity employer. Employment selection and reputed company decisions are made without regard to age, race, color, national reputed company, 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. reputed company accepts applications on an ongoing basis until a candidate is identified. Apply To This Job