[Hiring] Network Contracting Lead @CareMore Health

Role Description

The Network Contracting Lead is a senior-level individual contributor who operates with significant independence and serves as a recognized subject matter expert in provider contracting. This role ensures access to high-quality, cost-effective healthcare services while supporting value-based care arrangements, regulatory compliance, network adequacy, and strong provider partnerships across CareMore's markets.

• Develops, negotiates, and manages complex provider agreements that support CareMore's care delivery model, provider network strategy, and financial and operational objectives.
• Provides strategic expertise in provider reimbursement, process excellence, and network development, focusing on supporting CareMore's Medicare Advantage populations and coordinated care delivery.
• Partners closely with Finance, Legal, Clinical Leadership, Provider Relations, Market Operations, and executive leadership to develop contracting solutions that improve provider alignment, financial performance, patient access, and quality outcomes.
• Independently evaluates contracting opportunities, resolves complex provider and reimbursement challenges, and makes strategic recommendations that influence market-level and enterprise-wide network performance.

Qualifications

• Experience in provider contract negotiation and management.
• Strong understanding of value-based care and reimbursement strategies.
• Ability to analyze provider performance and market competitiveness.
• Excellent collaboration and communication skills.
• Proven track record of strategic advisory in a healthcare setting.

Requirements

• Lead complex provider contract negotiations involving physician groups, specialists, hospitals, ancillary providers, health systems, and other healthcare partners.
• Develop and execute contracting strategies that support CareMore's clinical model, patient access requirements, network adequacy, financial objectives, and market-specific needs.
• Independently evaluate and negotiate reimbursement terms, contract structures, performance requirements, and value-based arrangements.
• Manage complex contract renewals, amendments, terminations, and renegotiations.
• Partner with market and clinical leadership to evaluate provider network needs and develop contracting solutions.
• Evaluate provider performance, market competitiveness, reimbursement trends, and network adequacy.
• Develop and negotiate provider agreements that support value-based care and quality improvement.
• Analyze provider reimbursement, contract performance, utilization trends, and financial outcomes.
• Ensure compliance with applicable federal and state regulations, Medicare Advantage requirements, and organizational policies.
• Serve as a recognized subject matter expert in provider contracting and reimbursement methodologies.

Benefits

• Competitive salary range: $130,159.00 to $195,238.00.
• Comprehensive health benefits.
• Retirement savings plans.
• Opportunities for professional development.