Director, Network Contract and Strategy

L.A. Care Health Plan•Los Angeles, CA

1d•$149,502 - $254,152•Onsite

About The Position

The Director, Network Contract and Strategy develops strategic plans, drives change and influences critical business outcomes with network contracts which advance organizational goals across medical groups, hospitals, and health systems. This role translates network strategy, market dynamics, membership needs, financial objectives, quality priorities, and regulatory requirements into actionable contracting solutions. Identifies and assesses contracting opportunities, leads negotiations for new contracts and renewals, and maintains a proactive contract pipeline. Partners with key stakeholders to evaluate financial impacts and ensure contracts align with business and regulatory standards. Represents the Health Plan in high-level provider meetings and strategic partnerships. Oversee operations, ensuring efficiency and effectiveness and is responsible for directing all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.

Requirements

Bachelor's Degree In lieu of degree, equivalent education and/or experience may be considered.
At least 8 years of progressively responsible experience in managed care, healthcare contracting, provider network management, network strategy healthcare finance, or related discipline.
Demonstrated experience with complex provider contracting and negotiations. This includes experience developing or executing network strategies that balance member access, network adequacy, provider performance, affordability, quality, regulatory requirements, and long-term provider relationships.
At least 6 years of leading staff, supervising staff or people management experience.
Experience with direct or matrixed leadership of professional staff, cross-functional initiatives, or complex contracting and network strategy activities.
Demonstrated experience developing, negotiating, and executing complex provider agreements, including contracts with Hospitals, Health Systems, Medical Groups/IPAs, physicians, ancillary providers, post-acute providers, or other strategic network partners.
Demonstrated experience evaluating provider economics, reimbursement proposals, utilization, membership, market dynamics, and financial impact.
Advanced contract negotiation skills and a deep understanding of managed care contracting and reimbursement methodologies.
Exceptional strategic and financial acumen, leveraging strong analytical and decision-making capabilities to assess and articulate provider strategic value and network importance.
Proven ability to manage multiple concurrent negotiations and strategic priorities.
Ability to exercise sound judgment in situations involving financial exposure, provider disruption, network adequacy risk, regulatory sensitivity, or executive escalation.
Expert knowledge of contract governance and implementation. Ability to ensure that agreements are executed with precision and aligned with organizational objectives.
Expert written, verbal communication, presentation and negotiation skills.
Ability to foster strong relationships with internal and external stakeholders.
Demonstrated ability to navigate complex environments and deliver results.
Demonstrated ability to think long-term and develop strategies that align with the overall goals of the organization.
Demonstrated ability to make sound and timely decisions.
Demonstrated ability to adapt to changing situations and adjust strategies accordingly.
Demonstrated ability to adapt to a fast-paced and evolving environment and to lead others through change.
Excellent interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment.
Travel to offsite locations for work required.

Nice To Haves

Master's Degree
Extensive experience negotiating with large medical groups, IPAs, hospitals, integrated delivery systems, and health systems, consistently securing agreements that advance organizational objectives.
Experience supporting multiple lines of business, including Medi-Cal, Medicare Advantage, Commercial, and Marketplace products.
Demonstrated ability and knowledge of diverse payer environments.
Strong knowledge of value-based care, shared risk, full risk, delegated, and other advanced provider arrangements.
Strong ability to structure innovative contracts that drive quality and financial performance.
Expert knowledge of multi-year network strategies, provider segmentation models, and contracting governance bodies, and senior decision-making forums.
Ability to act as a trusted advisor and strategic partner, capable of navigating complex negotiations and advancing the organization’s network and contracting priorities.

Responsibilities

Responsible for shaping and executing contracting strategies that drive organizational success across medical groups, hospitals, and health systems.
Serve as a senior contracting representative, translate complex network strategies, market dynamics, membership needs, financial objectives, quality imperatives, and regulatory requirements into actionable, high-impact contracting solutions.
Identify and assess contracting opportunities. Evaluate network needs, geographic access, market position, quality, utilization, cost, and strategic importance.
Develop robust negotiation strategies and recommend positions for new contracts, renewals, amendments, and material contract changes.
Ensure the organization maintains a forward-looking contract pipeline, proactively identifies upcoming renewals, strategic opportunities, network gaps, and high-priority negotiations.
Responsible for contract development and rate evaluation, lead the creation, review, and refinement of provider contract language and exhibits.
Draft and negotiate business terms within established organizational and financial parameters, rigorously evaluate proposed provisions for business, financial, operational, regulatory, and network implications.
Partner closely with cross functional teams to assess the financial impact of proposed reimbursement changes, ensuring that rationale, financial assumptions, concessions, and required approvals are clearly documented and escalated when necessary.
Own the contracting process from initial negotiation through final execution.
Ensure that negotiated terms are accurately incorporated into final contracts and exhibits, maintain comprehensive documentation, monitor contracting timelines, and proactively address barriers to execution.
Develop and mentor a high-performance contract management and execution team, capable of securing strategically important provider agreements, negotiating sustainable and financially responsible reimbursement, executing renewals and amendments efficiently, and reducing unnecessary contractual variation and risk.
Represent the Health Plan in high-level provider meetings, community forums, and strategic partnerships.
Serve as a trusted ambassador, advancing organizational excellence and forging impactful external relationships.
Develop goals, objectives and actions plans for assigned staff which includes full management responsibility for the hiring, performance reviews, salary reviews and disciplinary matters for direct reporting employees.
Foster and promote a culture of transparency, continuous improvement, accountability, and shared ownership of enterprise goals.
Manage department budgets and resources effectively.
Conduct strategic planning to utilize resources to meet current and future departmental and Enterprise-wide goals.
Lead discussions on policy operationalization and manages key policy perspective sharing.
Performs other duties as assigned.