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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:
What are popular job titles related to Director Provider Network Development jobs in Georgia? For Director Provider Network Development jobs in Georgia, the most frequently searched job titles are:
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Director Provider Network Development jobs near you
Senior Manager, Provider Contract Negotiations (Georgia)

Senior Manager, Provider Contract Negotiations (Georgia)

CVS Health

Conyers, GA • On-site

$67K - $149K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted yesterday

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,285 frontline employees who took The Breakroom Quiz

81st of 104 rated pharmacies

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

  • Negotiates, executes, and analyzes contracts with larger and more complex healthcare group/system providers, focusing on maintaining and enhancing the provider network while meeting accessibility, quality, and financial goals related to accessibility, quality and financial performance.
  • Manages and facilitates dispute resolution processes to address issues arising from provider contracts, ensuring equitable solutions.
  • Leverages negotiation skills and working knowledge of provider financial issues to optimize contracts and collaborate with large hospitals and health systems to achieve successful contracting outcomes, all while supporting cost-saving initiatives and the growth of the provider network
  • Leads contract settlement negotiations, striving to reach mutually beneficial agreements with providers that maintain and enhance the provider network.
  • Implement strategies to enhance and expand the provider network, while ensuring it meets accessibility and quality standards.
  • Aligns provider contracts with financial goals and cost-saving initiatives, ensuring that contracts support the company's financial objectives.
  • Conducts comprehensive reviews and analyses of provider contracts, identifying areas for improvement and optimization.
  • Ensures that all provider contracts adhere to regulatory requirements, maintaining compliance with healthcare regulations.
  • Utilizes working knowledge of provider financial issues and competitor strategies to inform negotiation and contracting decisions.
  • Facilitates leadership, guidance, and mentorship to a team of professionals by setting strategic objectives, monitoring team performance, providing training and development opportunities, and fostering a collaborative and innovative work environment.
  • Partner cross-functionally with key stakeholders across the organization.


Required Qualifications

  • 7+ years of provider contract negotiation experience, working with healthcare providers, including hospitals, physicians, specialists and ancillary service providers.
  • Addition skills include a growth mindset (agility and developing yourself and others) skills; execution and delivery (planning, delivering, and supporting) skills; business intelligence and communication skills across multiple levels of leadership.
  • Proven ability to manage competing priorities and deliver high quality work.
  • Candidate must reside near the Atlanta, GA area and is required to report to Atlanta office at least 1x per month.

Preferred Qualifications

  • Hands-on experience with value-based contracting and alternative payment arrangements.


Education

  • Bachelor's Degree preferred, or equivalent professional experience

Pay Range

The typical pay range for this role is:

$67,900.00 - $149,328.00


This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 07/31/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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