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Director Provider Network Development Jobs in New Mexico

Lowe's

Field PROvider Manager

Albuquerque, NM

Manages the relationship and performance of the service provider network through direct interaction with the service providers and B2B meetings leveraging insights/takeaways from Centralized Business ...

Peraton

Director, Business Development

Albuquerque, NM · On-site

$176K - $282K/yr

As a key member of our Space & Intelligence Sector, you will provide leadership, critical thought ... A deep network of relationships across Air Force and Space Force acquisitions and operations teams.

Peraton

Director, Business Development

Albuquerque, NM · On-site

As a key member of our Space & Intelligence Sector, you will provide leadership, critical thought ... A deep network of relationships across Air Force and Space Force acquisitions and operations teams.

MECA Therapies LLC

Home Visiting Provider

Alamogordo, NM · On-site

$11 - $14/hr

Providing parenting education to include developmental guidance and interaction to support school ... Receiving reflective supervision and/or reflective consultation with regional director and clinical ...

MECA Therapies LLC

Home Visiting Provider

Alamogordo, NM

$11 - $14/hr

Providing parenting education to include developmental guidance and interaction to support school ... Receiving reflective supervision and/or reflective consultation with regional director and clinical ...

MECA Therapies LLC

Home Visiting Provider

Alamogordo, NM · On-site

$11 - $14/hr

Providing parenting education to include developmental guidance and interaction to support school ... Receiving reflective supervision and/or reflective consultation with regional director and clinical ...

Cardinal Health

Job Summary The Director, Corporate Development will be a key member of the team, focusing on M&A ... Provides leadership to managers and experienced professional staff; may also manage front line ...

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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.
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Director Provider Network Development jobs near you
Infographic showing various Director Provider Network Development job openings in New Mexico as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, and 4% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution.
Provider Network Management Relations Executive

Provider Network Management Relations Executive

Presbyterian Healthcare Services

Albuquerque, NM • On-site

$53K - $91K/yr

Full-time

Medical, Dental, Vision, Life

Posted 17 days ago

Presbyterian Healthcare Services rating

7.0

Company rating: 7.0 out of 10

Based on 162 frontline employees who took The Breakroom Quiz

417th of 890 rated healthcare providers

Job description

Location Address:
9521 San Mateo NEAlbuquerque, NM 87113-2237
Compensation Pay Range:
Minimum Offer $53,768.00Maximum Offer $91,520.00Now Hiring: Provider Network Management Relations Executive
Summary:
Build your Career. Make a Difference. Presbyterian is hiring a skilled Provider Network Management Relations Executive to join our team.Type of Opportunity: Full timeJob Exempt: YesJob is based: Reverend Hugh Cooper Administrative CenterWork Shift: Weekday Schedule Monday-Friday (United States of America)
Responsibilities:
Job Description
Presbyterian Healthcare is seeking a Provider Network Management Relations Executive.
Provides oversight of network strategies and relationship development activities for assigned providers including individualized planning, training and development of providers to align with Presbyterian s clinical quality initiatives. Will provide the framework for physician/provider performance reporting that will assist providers with objective and quantitative analysis of clinical quality performance measures. The Network Relations Service Executive is a professional accountable for proactively identifying issues, resolving disputes, and coordinating resolutions. Accountable for resolving complex problems, fielding general questions, and acting as a liaison between the provider of service and the health plan.
Some key responsibilities include:
  • Collaborates and maintains relationships with providers and staff throughout Presbyterian to ensure an exceptional provider experience.
  • Develops and maintains cooperative working relationships between PHP, institutional provider and individual providers.
  • Provides education on quality initiatives, managed care, capitation, products, policies and procedures, reimbursement issues, referral/authorization process, etc.
  • Responsible for ensuring provider data integrity and accuracy by ensuring PIF s are completed timely and accurately and through a comprehensive review and validation of provider directory data.
  • Responsible for post payment validation of assigned providers to ensure accuracy of payment to the contract and corresponding fee schedules.
  • Resolves provider issues - claims, health services, finance, etc.
  • Stimulates and fosters professional development of the Network Relations Service Associates.
  • Supports Network Contracting strategies in an effort to preserve a robust provider network.
  • Serves as primary liaison between the provider and the health plan.
  • Maintains a general knowledge of health plan reimbursement methodologies.
  • Conducts provider visits based on established departmental goals, which will require 50-65% field contact.
  • Engages and supports leadership and peers by promoting and participating in department initiatives and being accountable for achieving business objectives

Qualifications:
  • Three years experience in provider relations, provider contracting, claims processing, or customer service in a healthcare organization. Strong working knowledge of risk sharing programs and different reimbursement methodologies i.e. capitation, DRG, Relative Value Systems, etc. Must demonstrate strong verbal, written communication, and presentation skills with strong interpersonal and negotiations skills and ability to interface with providers. Must also possess strong facilitation, organizational, and personal computing skills
  • Education:
    Essential:
    High School Diploma or GED

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services

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About Presbyterian Healthcare Services

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Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Albuquerque, NM, US

Year founded

1908

Social media

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