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AVP - Provider Strategy & Contracting

CareCentrix -
Remote

Apply Now

Job Details

Full-time
$180,000 - $226,000 a year

Benefits

Paid parental leave
Health savings account
Health insurance
Dental insurance
Paid time off
Parental leave
Vision insurance
401(k) matching

Qualifications

Talent management
Contract management experience in healthcare
Bachelor's degree
Medical credentialing
Contracts
Leading team collaboration initiatives
Procurement contract negotiation
Cross-functional team management
Project stakeholder communication
Cross-functional communication

Full Job Description

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 position provides people leadership for the Network Contracting and Credentialing teams, driving talent development, operational excellence, and cross-functional collaboration to support organizational objectives.

The role leads provider partnership strategy, network contracting, rate negotiations, network adequacy, credentialing operations, and performance optimization across multiple product lines, including durable medical equipment (DME), home infusion therapy, sleep management, traditional home health, and other ancillary services.
In this role, you will develop and implement scalable contracting models and network strategies that build and maintain high-performing provider networks. Responsibilities include oversight of the full contract lifecycle, negotiation frameworks, provider reimbursement methodologies, network expansion initiatives, credentialing processes, and value-based or performance-driven arrangements where applicable.

You will partner cross-functionally to enhance network capabilities, ensure adequate provider coverage to meet patient needs, strengthen provider engagement, and drive operational excellence throughout the provider lifecycle—from provider recruitment, contracting, onboarding, and credentialing through performance management, network optimization, and contract renewal. Through effective leadership of the contracting and credentialing functions, you will ensure the organization maintains a compliant, high-quality, and cost-effective provider network that supports growth and delivers exceptional patient outcomes.

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
Strong organizational leadership skills with a track record of developing talent, fostering collaboration, and building accountable, high-performing cultures
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.

Apply Now

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Director Development

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