Director, Provider Contracting @ Gravie

Gravie

5d•$140,325 - $187,100

About The Position

Gravie is seeking an experienced contracting expert to lead the provider contracting strategy for its health plan. This is a senior, strategic role responsible for value-based care contracting, negotiating complex network agreements, managing network delegation relationships, and serving as the product/tech lead for contracting and network systems. The role is crucial for launching new provider networks in new markets and reports into network leadership, collaborating with Finance, Actuarial, Compliance, Product, and Engineering. The goal is to build a scalable network strategy that supports business growth.

Requirements

Bachelor's degree, or equivalent experience, and 8+ years of experience in provider contracting, network management, or healthcare reimbursement.
5+ years of experience negotiating value-based care arrangements, including risk-based and shared savings models.
5+ years of experience independently drafting and negotiating complex healthcare contracts and delegation agreements.
5+ years of experience leading network contracting strategy and managing relationships with providers, facilities, or vendors.
3+ years of experience managing delegated entities, including delegate oversight, audits, and compliance.
4+ years of experience ensuring contracts and network operations comply with CMS and state insurance regulations.
2+ years of experience partnering with Product or Engineering teams to shape systems or tooling requirements.
Proven track record leading new network builds or market launches from contracting through go-live.

Nice To Haves

Experience launching provider networks in new geographies or markets.
Experience at a small or mid-sized health plan where cross-functional collaboration is a must.
Familiarity with contracting or network configuration systems and how they're built or improved.
Previous startup company experience.
Project or program management experience.

Responsibilities

Own the end-to-end contracting process for new markets, delivering signed, competitively priced agreements with providers, facilities, and vendors.
Own the recoupment function end to end: set provider outreach strategy, decide resolution on contested recoupments, and manage the interface with Claims and Finance.
Own the performance, compliance, and oversight of delegated entities (e.g., credentialing, repricing, utilization management), including audits and corrective action plans.
Serve as the network team's lead partner to Product and Engineering, shaping requirements for contracting, provider data, and network configuration systems.
Lead design and negotiation of value-based care arrangements (shared savings, risk-based, and bundled payment models) with health systems and provider groups.
Independently draft, negotiate, and finalize complex provider and vendor contracts, delegation agreements, and amendments.
Own new network contracts and launches, acting as the accountable lead for building compliant, competitively priced networks in new geographies.
Manage network delegation relationships end-to-end, including delegate oversight, audits, and performance management.
Ensure all contracts and network operations meet CMS, state DOI, and network adequacy requirements.
Partner with Finance and Actuarial to build and refine reimbursement strategy.
Analyze network adequacy and market dynamics to identify expansion opportunities and recruitment priorities.
Serve as the senior escalation point for provider and vendor contract disputes.
Track industry trends and competitor positioning to keep Gravie's contracting strategy ahead of the market.
Partner with executive leadership on network strategy, budgeting, and cost-containment initiatives.