Network Partnerships Lead

New

Skills

Contract Negotiation Data Analytics Performance management Strategic Planning

Job Overview

Own the strategy, contracting, implementation, and performance management of provider network and care pathway partnerships. Develop differentiated network configurations to support broker distribution. Build partnerships with centers of excellence, specialty providers, and clinical programs. Ensure pathways are operationally executable, measurable, and scalable.

Responsibilities
  • Own the strategy, contracting, implementation, and performance management of provider network and care pathway partnerships.
  • Identify and evaluate new provider network opportunities.
  • Develop differentiated network configurations to support broker distribution.
  • Ensure network economics align with underwriting and pricing strategy.
  • Build partnerships with centers of excellence, specialty providers, and clinical programs.
  • Structure bundled pricing or value-based agreements.
  • Integrate care pathways into clinical and claims workflows.
  • Lead negotiations with provider groups, networks, and specialty partners.
  • Establish performance-based terms, SLAs, data-sharing requirements, and governance.
  • Define and track KPIs for cost, access, utilization, and member experience.
Requirements & Qualifications
  • 7–10+ years of experience in provider networks, care delivery partnerships, or TPA/health plan operations.
  • Direct experience in negotiating and contracting provider or network agreements.
  • Strong understanding of claims administration, stop-loss structures, and reimbursement models.
  • Proven ability to lead cross-functional initiatives from strategy through execution.
  • Working within or alongside a TPA, carrier, MGU, or self-funded plan environment.
  • Exposure to value-based contracting models (nice to have).
  • With broker-distributed health plans (nice to have).
  • Familiarity with level-funded or self-funded plan design (nice to have).

Job Type: Remote

Salary: Not Disclosed

Experience: Entry

Duration: 12 Months

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