ZipRecruiter

Log In

1

Director Provider Network Management Jobs (NOW HIRING)

Elevance Health

$113 - $170/hr

Provider Network Management Director-Colorado Anticipated End Date: 9/12/2026 Location: Denver, Colorado. This role requires associates to be in-office 3 days per week, fostering collaboration and ...

Sonrava Health

Provider Network Manager

Sacramento, CA · Remote

$80K - $85K/yr

... network management throughout Northern California. This full-time, remote position is an excellent opportunity for a motivated professional who enjoys building strong provider relationships ...

Sonrava Health

Provider Network Manager

Sacramento, CA · On-site +1

$80K - $85K/yr

... network management throughout Northern California. This full-time, remote position is an excellent opportunity for a motivated professional who enjoys building strong provider relationships ...

next page

Showing results 1-20

All JobsBusiness JobsMarketing JobsStrategic Partnership Manager JobsDirector Provider Network Management Jobs

Director Provider Network Management information

See salary details

$48.5K

$130.2K

$269K

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

As of Aug 31, 2026, the average yearly pay for director provider network management in the United States is $130,243.00, according to ZipRecruiter salary data. Most workers in this role earn between $83,500.00 and $148,500.00 per year, depending on experience, location, and employer.

What does a director provider network management do?

A Director of Provider Network Management oversees the development and maintenance of healthcare provider networks for insurance companies, health plans, or healthcare organizations. They are responsible for negotiating and managing contracts with hospitals, physicians, and other healthcare providers to ensure quality care and cost-effectiveness. Their role also involves analyzing network performance, ensuring regulatory compliance, and leading a team to optimize provider relationships and network expansion.

What are the main challenges a director provider network management typically faces in maintaining provider relationships?

Directors of Provider Network Management often encounter challenges such as negotiating favorable contract terms, ensuring provider compliance with quality standards, and balancing cost containment with network adequacy. They must navigate complex regulatory requirements and address concerns from both providers and internal stakeholders. Building and maintaining positive relationships requires strong communication skills, as well as the ability to resolve disputes and align network strategies with organizational goals.

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

To thrive as a Director of Provider Network Management, you need deep knowledge of healthcare networks, contract negotiation, and provider relations, usually backed by a bachelor's or master's degree in healthcare administration or a related field. Familiarity with provider management systems, data analytics tools, and regulatory compliance platforms is typically required. Exceptional leadership, strategic thinking, and relationship-building skills help drive team performance and foster strong partnerships with providers. These abilities are crucial for optimizing network performance, ensuring regulatory compliance, and achieving organizational goals in a complex healthcare landscape.

What is the difference between Director Provider Network Management vs Provider Relations Manager?

AspectDirector Provider Network ManagementProvider Relations Manager
CredentialsHealthcare management, industry certificationsHealthcare or business-related certifications
Work EnvironmentStrategic planning, leadership, cross-department collaborationProvider communication, relationship building, contract negotiations
Employer & Industry UsageHealth insurance companies, managed care organizationsHealth plans, provider networks, healthcare organizations
Search & Comparison IntentHigh-level network management, strategic oversightProvider engagement, relationship management

The main difference is that the Director Provider Network Management oversees the entire provider network strategy and operations, focusing on high-level management and planning. In contrast, the Provider Relations Manager concentrates on maintaining and strengthening relationships with individual providers, handling day-to-day communication and negotiations.

What cities are hiring for Director Provider Network Management jobs?

Cities with the most Director Provider Network Management job openings:

What are the most commonly searched types of Provider Network Management jobs?

The most popular types of Provider Network Management jobs are:

What states have the most Director Provider Network Management jobs?

States with the most job openings for Director Provider Network Management jobs include:

Director Provider Network Management jobs near you
Infographic showing various Director Provider Network Management job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $130,243 per year, or $62.6 per hour.

Director Provider Network Management

AmeriHealth Caritas Health Plan

Manchester, NH • On-site

Full-time

Re-posted yesterday

AmeriHealth Caritas rating

8.3

Company rating: 8.3 out of 10

Based on 73 frontline employees who took The Breakroom Quiz

133rd of 315 rated insurance

Job description

Role Overview: The Director, Provider Network Management, is responsible for developing and executing the provider network strategy across all AmeriHealth Caritas New Hampshire lines of business. Reporting directly to the Market President and serving as a key member of the Executive Leadership Team, this leader will drive provider network performance, affordability, quality outcomes, population health initiatives, and provider satisfaction while strengthening AmeriHealth Caritas' position as the preferred healthcare partner throughout New Hampshire.
Work Arrangements:
  • Hybrid - Associate must be located in New Hampshire and work onsite at the Manchester, NH office three days per week.

Responsibilities:
  • Drive market provider network development and network management strategies to support business growth, network adequacy, and member access across all lines of business.
  • Develop and execute the annual provider network strategy, ensuring compliance with network adequacy requirements and establishing a competitive, marketable provider network.
  • Lead initiatives to improve provider satisfaction while ensuring compliance with pricing guidelines established by AmeriHealth Caritas Health Plan (AHC) and Plan leadership.
  • Monitor Single Case Agreement (SCA) trends and implement contracting strategies to reduce out-of-network utilization and improve network efficiency.
  • Provide leadership, coaching, performance management, and staffing oversight for the Provider Network Management team, including hiring, annual evaluations, and development planning.
  • Ensure departmental compliance with all federal and state regulations, accreditation standards, policies, and procedures; develop and revise departmental policies as needed.
  • Partner closely with the Market Director of Quality to advance key quality initiatives and performance measures, including Healthcare Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Healthcare Providers and Systems (CAHPS), and National Committee for Quality Assurance (NCQA)/Utilization Review Accreditation Commission (URAC) standards.
  • Review provider satisfaction survey results and lead the development and implementation of action plans to address opportunities for improvement and enhance the provider experience.
  • Maintain accountability for the timely resolution of provider disputes, escalations, and contract-related concerns.
  • Oversee provider network performance and access, ensuring adequate geographic coverage and appropriate availability of services throughout the health plan's service area.
  • Bring strong operational knowledge related to provider satisfaction, provider education, and provider communications, with expertise in claims, payment integrity, provider data management, credentialing, appeals, and dispute resolution processes.
  • Provide oversight for large-scale provider terminations and network disruption mitigation strategies.
  • Ensure provider contracts align with approved reimbursement and claims payment methodologies.
  • Manage non-standard contract provisions, ensuring appropriate tracking, communication, and required approvals from AHC and Plan leadership before provider submission.
  • Lead complex negotiations with hospitals, health systems, physician groups, ancillary providers, and clinically integrated networks, including Value-Based Care (VBC) agreements and alternative payment models.
  • Provide strategic oversight of all facility, physician, ancillary, and physician extender network development and management activities.
  • Serve as the lead negotiator for high-impact provider agreements and Value-Based Care (VBC) arrangements as needed.
  • Perform other duties and strategic initiatives as assigned.

Education & Experience:
  • Bachelor's degree in business or health-related disciplines, such as healthcare administration or healthcare management, and equivalent business experience is preferred.
  • 3 years of experience in managed care provider contracting and reimbursement is required, including in-depth knowledge of reimbursement methodologies and contracting terms.
  • 1 to 2 years of Medicaid experience.
  • 8 to 10 years of progressive business management and negotiation experience.
  • 5 years of management experience, managing teams, and project management.
  • Demonstrated success across Medicaid, Medicare Advantage, D-SNP, and/or Exchange products.
  • Strong financial, analytical, negotiation, and executive communication skills.
  • Proven experience leading complex organizational and provider transformation initiatives.

Licensure:
  • Valid driver's license and current car insurance are required.

Skills & Abilities:
  • Strong financial acumen with experience analyzing provider economics, reimbursement methodologies, health plan performance, and business impact.
  • Advanced analytical capabilities with experience leveraging provider performance data, predictive analytics, business intelligence tools, and market intelligence to drive strategic decision-making.
  • Outstanding negotiation and influencing skills with a proven track record leading complex facility, physician, and value-based contracting negotiations.
  • Ability to develop and implement large-scale organizational change, provider transformation initiatives, and operating model enhancements.
  • Strong understanding of provider operations, claims administration, payment integrity, credentialing, provider data management, appeals, grievances, and dispute resolution processes.
  • Experience developing provider engagement, provider satisfaction, and provider communication strategies that improve provider experience and operational effectiveness.
  • Excellent verbal, written, presentation, and executive communication skills with the ability to effectively engage boards, executive leadership, providers, and government stakeholders.
  • Demonstrated ability to lead cross-functional teams, influence without direct authority, and build consensus across complex organizational environments.
  • Strategic thinker with the ability to anticipate market trends, identify growth opportunities, and align provider strategy with organizational goals.
  • Ability to balance quality outcomes, affordability, member experience, and provider satisfaction while driving measurable business results.
  • Strong project management and organizational skills with the ability to manage multiple priorities in a fast-paced, highly regulated environment.
  • Proficiency with healthcare analytics platforms, provider performance reporting tools, Microsoft Office Suite, and other healthcare technology solutions.
  • Commitment to fostering a culture of accountability, collaboration, innovation, continuous improvement, and member-centered care.

What AmeriHealth Caritas employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply