Senior Vice President, Provider Network Management
About The Position
Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth. Who Are We? ✨ Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values. Why Join Us? 🏆 We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation. Job Summary The Senior Vice President, Provider Network Management is responsible for the enterprise-wide strategy, development, performance, and growth of the provider network. This role establishes and leads the long-term vision for provider partnerships across markets, ensuring the network strategy supports growth, access, quality, affordability, and value-based care objectives. Serves as the organization’s senior executive on provider networks, directing provider development, contracting strategy, network adequacy, and provider relationship management.
Requirements
- Bachelor’s degree in Business, Healthcare Administration, or related field required.
- 10+ years of provider network development and contracting experience.
- 5+ years of value-based care or risk-based contracting experience.
- Executive presence with ability to influence senior leaders.
- Deep expertise in provider contracting and value-based care models.
- Strong strategic and execution capabilities.
- Exceptional relationship-building and negotiation skills.
- Ability to lead in highly matrixed environments.
- Must be located in Los Angeles or Orange County
Nice To Haves
- Master’s degree (MBA, MHA) or equivalent experience preferred.
- Medicare Advantage experience strongly preferred.
Responsibilities
- Establish and lead the enterprise provider network strategy aligned with organizational growth, access, quality, and value-based care goals.
- Define network design principles across primary care, specialty, hospital, ancillary, and delegated provider models.
- Ensure network strategies anticipate regulatory, competitive, and market dynamics.
- Serve as executive advisor to senior leadership on provider network planning and evolution.
- Lead physician, provider group, IPA, and health system relationship strategy.
- Build and maintain long-term provider partnerships that support growth and retention.
- Oversee provider onboarding, alignment, and relationship management frameworks.
- Represent the organization with key external provider stakeholders.
- Oversee provider contracting strategy, including value-based and risk-based arrangements.
- Guide contract structures, reimbursement models, and incentive alignment.
- Lead analysis of utilization trends, reimbursement benchmarks, and market economics.
- Support network-related due diligence for expansion and partnerships.
- Ensure network adequacy, access standards, and regulatory compliance across markets.
- Oversee performance monitoring related to access, cost, quality, and growth.
- Establish governance, policies, and operational standards for network management.
- Drive continuous improvement through data-driven insights.
- Lead and develop provider network management leaders and teams.
- Build a high-performing and accountable organization.
- Partner with Sales, Marketing, Finance, Medical Management, and Product leaders to enable enterprise goals.
- Champion innovation and change within provider network strategy and operations.
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What This Job Offers
Job Type
Full-time
Career Level
Executive
