Director, Contracting & Network Development

Director, Contracting & Network Development 📍 Location: Clayton, Missouri, United States (Remote) 🏢 Industry: Insurance 💼 Work Setting: Remote (Continental U.S.) with occasional travel. Are you passionate about building high-performing provider networks, leading complex contract negotiations, and driving strategic growth in the healthcare industry? We are seeking an experienced Director of Contracting & Network Development to lead network strategy, provider partnerships, and contracting initiatives while driving market expansion, operational excellence, and financial performance across assigned markets. Key Responsibilities Network Strategy & Development • Develop and execute comprehensive provider network strategies aligned with organizational goals, market demands, and growth initiatives. • Assess market conditions, provider accessibility, competitive landscapes, and network performance to identify opportunities for expansion and optimization. • Evaluate network adequacy, provider coverage, and service delivery capabilities to ensure high-quality member access and satisfaction. • Lead strategic planning efforts for network growth, market entry, and business expansion initiatives. Provider Contracting & Negotiation • Lead complex negotiations with hospitals, health systems, physician organizations, ancillary providers, and other healthcare entities. • Negotiate reimbursement arrangements, contract terms, service agreements, and performance expectations. • Review and manage contract modifications, renewals, and redline negotiations while balancing organizational objectives and provider relationships. • Develop innovative contracting strategies that support cost management, quality outcomes, and network sustainability. • Establish and maintain strong relationships with provider executives and key stakeholders. Network Performance & Financial Management • Analyze network, provider, operational, and financial performance metrics to identify trends and improvement opportunities. • Develop and implement strategies to enhance provider performance, improve access, and optimize healthcare costs. • Monitor key performance indicators (KPIs) related to network effectiveness, utilization, quality, and financial outcomes. • Collaborate with internal teams to execute initiatives that improve network value and operational performance. Market Expansion & Business Growth • Support new market launches, geographic expansions, and strategic growth initiatives. • Evaluate provider capacity, market opportunities, resource requirements, and business risks associated with expansion efforts. • Develop market-specific strategies to strengthen provider participation and network competitiveness. • Partner with internal stakeholders to ensure successful implementation of business growth initiatives. Leadership & Team Management • Lead, mentor, and develop contracting, provider relations, and network management professionals. • Oversee talent acquisition, onboarding, performance management, coaching, and career development activities. • Foster a collaborative, accountable, and results-oriented team culture. • Manage external consultants and vendors supporting contracting and network development activities. • Drive continuous improvement and operational excellence across team functions. Stakeholder Collaboration & Communication • Collaborate with executive leadership, operations, finance, clinical, compliance, and business development teams to align network strategies with organizational objectives. • Present market insights, network performance updates, and strategic recommendations to senior leadership. • Build productive relationships with provider organizations and industry stakeholders. • Serve as a trusted advisor on contracting, market strategy, and network development matters. Operational Excellence • Monitor operational processes, contracting workflows, and team performance to identify efficiencies and quality improvement opportunities. • Implement best practices that enhance productivity, contract execution, and provider engagement. • Ensure compliance with internal policies, regulatory requirements, and contractual obligations. • Drive initiatives that improve operational effectiveness and organizational outcomes. Required Qualifications Education • Bachelor's degree in Business Administration, Healthcare Administration, Health Management, Finance, Public Health, or a related field. • Equivalent combination of education and relevant experience may be considered. Experience • Minimum 7 years of experience in provider contracting, network development, provider relations, healthcare strategy, or related healthcare business functions. • Proven experience negotiating complex agreements with hospitals, health systems, physician organizations, and ancillary healthcare providers. • Experience developing and executing provider network strategies in a managed care, health plan, healthcare services, or payer environment. • Previous leadership experience with responsibility for hiring, coaching, developing, and managing teams. Preferred Qualifications • Experience supporting government-sponsored healthcare programs, value-based care arrangements, or healthcare reimbursement models. • Strong understanding of healthcare provider contracting methodologies and network development strategies. • Experience leading market expansion, network optimization, or strategic growth initiatives. • Demonstrated success managing provider relationships at the executive level. • Experience overseeing consultants, vendors, or external contracting resources.