VP of Provider Relations

A healthcare organization is seeking a VP of Provider Relations and Contracting to oversee provider relationships and contracting activities within Managed Care programs , including Medicaid Managed Long-Term Care (MLTC), Dual Special Needs Plan (DSNP), and Medicare Advantage Plans (MAP) . This role focuses on network development, provider negotiations, compliance, and strategic growth . Responsibilities Include: Lead and manage the provider relations and contracting team , fostering a high-performance culture. Oversee provider credentialing , ensuring compliance with regulatory and contractual requirements . Manage relationships with hospitals, medical groups, and healthcare providers to ensure network adequacy. Lead high-profile negotiations with large healthcare entities to secure favorable terms. Define and execute provider relations strategies to support organizational goals and improve member care. Provide ongoing education and training to providers on compliance and contractual obligations. Collaborate with claims, care management, compliance, and quality departments to address concerns and optimize processes. Use data and analytics to monitor network performance and identify areas for improvement. Attend senior management meetings and contribute to organizational strategy. Ideal Qualifications: 10+ years of experience in provider relations, contracting, or network management within managed care. Proven experience negotiating contracts with hospitals, healthcare systems, and medical groups . Strong knowledge of credentialing processes and regulatory compliance . Leadership experience in managing and developing teams. Ability to work in a collaborative and strategic environment . Strong negotiation and communication skills to manage complex agreements. Salary: $140k - $200k/Year To apply, please send your resume to #J-18808-Ljbffr

Created: 2025-03-12