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Director Provider Network Development Jobs in Georgia

Paradigm

Provider Contract Lead

Atlanta, GA · On-site

$80K - $90K/yr

Perform additional duties as identified and directed by management. * Maintain reliable and ... Network Development, Managed Care, and/or Provider Services. * Specific vision abilities required ...

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Director Provider Network Development information

What are some common challenges faced by a director of provider network development, and how can they be addressed?

A Director of Provider Network Development often encounters challenges such as negotiating favorable contracts with providers, ensuring network adequacy, and balancing cost control with quality of care. Successfully addressing these issues requires strong relationship-building skills, an in-depth understanding of healthcare regulations, and the ability to analyze market trends. Collaborating closely with legal, compliance, and analytics teams can help streamline contract negotiations and maintain a competitive, high-performing network. Continual professional development and staying current with industry changes are also key for long-term success in this role.

What is the difference between Director Provider Network Development vs Provider Network Manager?

AspectDirector Provider Network DevelopmentProvider Network Manager
CredentialsBachelor's degree, industry certifications often preferredBachelor's degree, relevant certifications beneficial
Work EnvironmentStrategic planning, high-level decision making, cross-department collaborationOperational management, provider relations, network oversight
Employer & Industry UsageHealth insurance companies, managed care organizationsHealth plans, healthcare providers, insurance firms
Search & Comparison IntentStrategic development, network expansion, leadership rolesOperational management, provider relations, network maintenance

The main difference is that the Director Provider Network Development focuses on strategic growth and high-level planning of provider networks, while the Provider Network Manager handles day-to-day operations and provider relations. Both roles require industry knowledge and relevant certifications, but their scope and responsibilities differ significantly.

What are the key skills and qualifications needed to thrive as a director of provider network development, and why are they important?

To thrive as a Director of Provider Network Development, you need a deep understanding of healthcare networks, contract negotiation, and provider relations, typically supported by a bachelor’s or master’s degree in healthcare administration or a related field. Familiarity with healthcare analytics platforms, provider management systems, and knowledge of payer-provider contract regulations are crucial. Strong leadership, relationship-building, and strategic communication skills set top performers apart. These competencies are vital for building robust provider networks, ensuring compliance, and driving organizational growth in a competitive healthcare environment.

What does a director of provider network development do?

A Director of Provider Network Development is responsible for building, maintaining, and optimizing relationships with healthcare providers, such as hospitals and physician groups, on behalf of insurance companies or health plans. They negotiate contracts, ensure providers meet quality and cost standards, and help expand the provider network to meet organizational goals. This role often involves analyzing network performance, identifying gaps in coverage, and collaborating with internal teams to improve service delivery and member satisfaction.
What are the most commonly searched types of Provider Network Development jobs in Georgia? The most popular types of Provider Network Development jobs in Georgia are:
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Director Provider Network Development jobs near you

Provider Contract Lead

Paradigm

Atlanta, GA • On-site

$80K - $90K/yr

Full-time

Medical, Life, Retirement, PTO

Posted 7 days ago

Job description

Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm's business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.
We're proud to be recognized-again! For the fourth year in a row, we've been certified by Great Place to Work®, and for the third consecutive year, we've earned a spot on Fortune's Best Workplaces in Health Care™ list. These honors reflect our unwavering commitment to fostering a positive, inclusive, and employee-centric culture where people thrive.
Watch this short video for a brief introduction to Paradigm.
Develops and implements provider network and contract strategies, identifying the ambulatory surgery centers and specialists in geographic locations in which to concentrate resources for purposes of establishing a sufficient network of participating providers to serve and exceed the needs of our clients.
DUTIES AND RESPONSIBILITIES:
  • Executes provider contracts for acceptable reimbursement rates as determined by client requirements and prevailing market ranges.
  • Maintain a system to track contract negotiation and sales activity on an ongoing basis through company provided software applications.
  • Directs the preparation and negotiations of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with ambulatory surgery centers, physicians, hospitals, and other health care providers as needed.
  • Oversees the maintenance of all Provider contract information for given territory. Works with legal and corporate on an as needed basis to modify contract templates to ensure compliance with all contractual and/or regulatory requirements.
  • Seeks, contacts and creates single case agreements (SCA) to fulfill GAP's as needed by the business.
  • Develops relationships with providers and offers feedback if there are deficiencies in their response time, scheduling time and/or providing medical documentation in a timely manner.
  • Perform additional duties as identified and directed by management.
  • Maintain reliable and predictable attendance during scheduled work hours.
  • Utilizes AI tools to support day-to-day tasks, improve efficiency, and enhance output quality. Adopts new technologies as trained and applies them in alignment with established processes and guidelines.
  • Demonstrates a customer-first mindset by developing a broad and deep (where appropriate) understanding of Paradigm organization, products, operations, and customers. Prioritizes collaboration to meet customer needs and expectations and takes personal accountability for service quality.
  • Responsible for complying with Paradigm Information Security requirements and policies, for safeguarding Paradigm or Paradigm related passwords, and for notifying Paradigm of any Information Security incidents per policy SEC 10-12 Information Security Incident Management.

QUALIFICATION REQUIREMENTS:
  • Bachelor's Degree in a related field (Business Administration, etc.,) or equivalent experience.
  • 3 to 5 years of experience in Healthcare Administration, Network Development, Managed Care, and/or Provider Services.
  • Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
  • Ability to maintain attendance to support required quality and quantity of work.
  • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
  • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
  • Superior interpretation and research skills to readily identify problems, get to the root cause and achieve prompt resolution to problems and issues including analytical skills
  • Ability to organize, coordinate, and accomplish a high volume of work with minimum impact on quality
  • Exceptional interpersonal relations skills.
  • Superior verbal and written communication skills.
  • Knowledge of Excel and Word.
  • This position may require up to 10% travel.

Paradigm Benefits:
  • Health and wellness- We want our people to be and stay healthy, so we offer PPO, HDHP, and HMO health insurance options with Cigna and Kaiser (CA employees only).
  • Financial incentives - Paradigm's financial benefits help prepare you for the future: competitive salaries, 401(k) matching contributions, employer-paid life and disability insurance, flexible spending and commuter accounts, and employer-matched HSA contributions.
  • Vacation - We believe strongly that work-life balance is good for you and for our company. Our paid time off and personal holiday programs give you the flexibility you need to live your life to the fullest.
  • Volunteer time- We want our employees to engage with and give back to their communities in meaningful ways. Full and part-time employees receive one paid day per calendar year.
  • Learning and development: One of Paradigm's core values is expertise, so we encourage our employees to continually learn and grow. We support this in a variety of ways, including our new Learning Excellence at Paradigm (LEAP) program.

Paradigm believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming lives. We're striving to build a culture that better reflects the society we live in and empowers our team to deliver the highest levels of compassion and care to those we serve. For us, achieving this goal requires a workforce that respectfully embraces differences and commits to positive change, creating an environment where everyone is able to bring their whole self to work.
Paradigm complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Leave Management at leave.management@paradigmcorp.com.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
As a contractor with the State of Wisconsin, Paradigm complies with Wisconsin Contract Compliance Law (§16.765). Poster link: Contract Compliance Law Poster
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