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Director Provider Network Development Jobs in McLean, VA

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Director Provider Network Development information

See McLean, VA salary details

$43.5K

$83.5K

$163.8K

How much do director provider network development jobs pay per year?

As of Aug 23, 2026, the average yearly pay for director provider network development in McLean, VA is $83,495.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,600.00 and $98,600.00 per year, depending on experience, location, and employer.

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 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 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 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 job categories do people searching Director Provider Network Development jobs in McLean, VA look for?

The top searched job categories for Director Provider Network Development jobs in McLean, VA are:

What cities near McLean, VA are hiring for Director Provider Network Development jobs?

Cities near McLean, VA with the most Director Provider Network Development job openings:

Director Provider Network Development jobs near you
Infographic showing various Director Provider Network Development job openings in McLean, VA as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 11% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $83,495 per year, or $40.1 per hour.

Provider Network Management Contractor

Enlightened, Inc.

Washington, DC • On-site

$92K - $126K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 27 days ago

Job description

Company Overview

As one of the Washington metropolitan area's fastest-growing IT companies, Enlightened is always looking for creative, passionate, and responsible employees. We recognize that our intelligent and dedicated employees are our greatest asset, and we are continually expanding our talented and diverse team. If innovation, integrity, and a commitment to delivering exceptional results are key components of your success, we invite you to join Enlightened.

Work Arrangement

This is a hybrid position based in our Washington, DC office, conveniently located within walking distance of two Metro stations. Associates work four (4) days in the office and one (1) day remotely each week.

Position Summary

As a Provider Network Management Contractor, you will be responsible for contracting and re-contracting healthcare providers within an established network. In this role, you will develop and maintain strong provider relationships while supporting network growth, ensuring regulatory compliance, and negotiating agreements that support organizational goals.

Responsibilities

  • Support the organization's provider network development strategy.
  • Assist leadership with departmental initiatives related to provider satisfaction, education, and communication.
  • Negotiate provider contracts that support network strategy while ensuring an adequate, compliant, and competitive provider network.
  • Negotiate Single Case Agreement (SCA) rates and transition SCA providers into contracted network providers whenever appropriate.
  • Recruit and contract providers to address identified network adequacy gaps, including high-complexity specialties.
  • Ensure all provider agreements comply with applicable federal and state laws, regulations, policies, and internal procedures.
  • Support quality initiatives by negotiating contracts aligned with HEDIS, CAHPS, NCQA, and URAC standards.
  • Negotiate contracts that promote provider satisfaction and long-term network stability.
  • Collaborate with Corporate Provider Network Management to execute the annual contracting strategy and expand the provider network as business needs evolve.
  • Serve as a subject matter expert (SME) on provider reimbursement and fee schedules for complex specialties, including Federally Qualified Health Centers (FQHCs), Behavioral Health, Anesthesiology, and other specialty areas.
  • Provide guidance to Account Executives on reimbursement methodologies and claims resolution related to contracted providers.
  • Demonstrate a strong understanding of provider operations, including claims, payment integrity, provider data management, credentialing, appeals, and dispute resolution.
  • Negotiate provider agreements consistent with approved reimbursement methodologies.
  • Modify and expand the provider network to support new products and business initiatives.
  • Review contract language and collaborate with legal counsel to ensure favorable and compliant contract terms.
  • Support contracting activities across multiple product lines, including Exchange and Dual Special Needs Plans (D-SNP).
  • Partner with Account Executives to negotiate and implement Value-Based Care agreements.

Education & Experience

  • Associate's degree required.
  • Bachelor's degree preferred.
  • Master's degree strongly preferred.
  • Minimum of three (3) years of experience in provider network management, provider relations, or account management.
  • Minimum of one (1) year of provider contract negotiation experience.

Preferred Skills

  • Knowledge of provider reimbursement methodologies, including risk-based and value-based contracting.
  • Strong negotiation and relationship-building skills.
  • Ability to navigate challenging conversations professionally and effectively.
  • Strong financial and analytical skills.
  • Proficiency with Microsoft Office Suite, including Excel, Word, Outlook, and PowerPoint.
  • Excellent verbal and written communication skills.
  • Strong organizational skills with the ability to manage multiple priorities and deadlines.

Compensation

The anticipated hiring range for this position is $92,800 to $126,400 annually.
Actual compensation will be determined based on factors including relevant experience, education, certifications, specialized skills, and internal equity.

Benefits

The expected salary range for this position is listed above. Actual compensation will be determined based on experience and qualifications as well as internal equity and alignment with market data.

At Enlightened, we pride ourselves on offering a comprehensive and industry-competitive benefits package to our full-time employees. Our benefits include:

  • Medical/Dental/Vision Insurance with Health Savings Accounts (HSA)
  • Flexible Spending Accounts (FSA)
  • 401(k) Retirement Plan
  • Paid Holidays, Vacation, & Sick Leave
  • Professional Training & Development Reimbursement

Please note, these benefits are available exclusively to full-time employees of Enlightened.

Equal Opportunity Statement

Enlightened is proud to be an Equal Opportunity Employer and does 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, disability, or any other federal, state, or local protected class.