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Healthcare Provider Network Contractor Jobs (NOW HIRING)

Elevance Health

Provider Network Manager

Tucson, AZ · Hybrid

... care concepts is required. * Contracts may involve non-standard arrangements that require a ... PND > Network Contracting Please be advised that Elevance Health only accepts resumes for ...

Elevance Health

Provider Network Manager-CO

Denver, CO · On-site

$74K - $112K/yr

... care concepts is required. * Contracts may involve non-standard arrangements that require a ... PND > Network Contracting Please be advised that Elevance Health only accepts resumes for ...

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Healthcare Provider Network Contractor information

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How much do healthcare provider network contractor jobs pay per hour?

As of Jul 23, 2026, the average hourly pay for healthcare provider network contractor in the United States is $31.82, according to ZipRecruiter salary data. Most workers in this role earn between $14.90 and $28.37 per hour, depending on experience, location, and employer.

What is the difference between Healthcare Provider Network Contractor vs Healthcare Provider Relations Specialist?

AspectHealthcare Provider Network ContractorHealthcare Provider Relations Specialist
CredentialsRelevant certifications, such as CPC or CPC-H, often requiredSimilar certifications, with additional focus on communication skills
Work EnvironmentContract-based, often remote or office settings, working with networksOffice or healthcare facility, engaging directly with providers and internal teams
Employer & Industry UsageInsurance companies, healthcare networks, and third-party administratorsHospitals, health plans, and healthcare organizations
Search & Comparison IntentUnderstanding contractual roles in provider networksManaging provider relationships and communication

The Healthcare Provider Network Contractor primarily focuses on establishing and managing provider networks through contractual agreements, often working with insurance companies or networks. In contrast, the Healthcare Provider Relations Specialist emphasizes building and maintaining relationships with healthcare providers, ensuring effective communication and collaboration within healthcare organizations.

What are the key skills and qualifications needed to thrive as a Healthcare Provider Network Contractor, and why are they important?

To thrive as a Healthcare Provider Network Contractor, you need expertise in contract negotiation, knowledge of healthcare regulations, and a background in business or healthcare administration. Familiarity with provider management systems, claims processing software, and relevant certifications such as Certified Managed Care Professional (CMCP) are commonly required. Exceptional relationship-building, communication, and analytical skills help you collaborate effectively with providers and internal stakeholders. These skills are crucial for building strong, cost-effective networks that ensure quality care and compliance within the healthcare system.

What is a Healthcare Provider Network Contractor?

A Healthcare Provider Network Contractor is a professional responsible for negotiating, establishing, and maintaining agreements between healthcare providers (such as hospitals, clinics, and physicians) and health insurance companies or managed care organizations. They ensure that a network of qualified healthcare providers is available to patients under a specific insurance plan. Their work involves contract negotiations, compliance monitoring, and fostering relationships to ensure quality care and cost-effectiveness. This role is essential for ensuring that patients have access to a broad range of healthcare services within their insurance network.

What are some common challenges faced by Healthcare Provider Network Contractors when negotiating contracts with providers?

Healthcare Provider Network Contractors often encounter challenges such as aligning provider expectations with organizational reimbursement structures, navigating regulatory requirements, and managing tight timelines for network expansion. Successfully negotiating contracts requires balancing cost-effectiveness for the organization with competitive terms that appeal to providers. Additionally, they must maintain positive relationships with providers while ensuring compliance with state and federal regulations, which can be complex and frequently updated.
More about Healthcare Provider Network Contractor jobs
What cities are hiring for Healthcare Provider Network Contractor jobs? Cities with the most Healthcare Provider Network Contractor job openings:
What states have the most Healthcare Provider Network Contractor jobs? States with the most job openings for Healthcare Provider Network Contractor jobs include:
What job categories do people searching Healthcare Provider Network Contractor jobs look for? The top searched job categories for Healthcare Provider Network Contractor jobs are:
Healthcare Provider Network Contractor jobs near you
Infographic showing various Healthcare Provider Network Contractor job openings in the United States as of July 2026, with employment types broken down into 1% Locum Tenens, 74% Full Time, 7% Part Time, and 18% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $66,177 per year, or $31.8 per hour.
Network Contractor Provider Network Management

Network Contractor Provider Network Management

Amerihealth Caritas

Charleston, SC • On-site, Remote

Full-time

Medical, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

AmeriHealth Caritas rating

8.3

Company rating: 8.3 out of 10

Based on 72 frontline employees who took The Breakroom Quiz

108th of 281 rated insurance

Job description

Work Arrangement:

This position is a remote field based position. Must reside in South Carolina. Will make provider visits throughout the state.

Job Summary

The primary responsibility of the Network Contractor is contractingproviders, the contracting and re-contracting of providers in an established market.

Essential Functions:

  • Supports network development strategy.
  • Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication.
  • Responsible for negotiating contracts to execute on network strategy and ensure an adequate, compliant and marketable network.
  • Responsible for negotiating SCA rates and converting SCA providers to contracted.
  • Responsible for recruiting and contracting providers based on identified network adequacy gaps (high complexity).
  • Ensures all contracts are negotiated to be compliant with Federal and State rules, regulations, policies and procedures and follow all departmental policies.
  • Ensures contracts are supportive of Plan quality initiatives such as HEDIS, CAHPS and NCQA/URAC.
  • Negotiates contracts to support management of provider satisfaction.
  • Contractors will work with CPNM to manage the annual contracting schedule as well as supplement the network as new providers are available or needed.
  • Payment/fee schedule SME's to develop resources in complex specialties i.e. FQHCs, BH, anesthesia etc. These SMEs will be available to AEs when needed for support of claims resolution.
  • General Operational Knowledge related to provider satisfaction, education and communication with a fundamental understanding of operational items such as claims, payment integrity, provider data, credentialing, appeals disputes etc.
  • Negotiates provider contracts consistent with claim payment methodologies.
  • Augments and modifies the existing provider network to accommodate new products or clients as necessary.
  • Reviews contract language and collaborates with legal to ensure best contract terms.
  • Support contracting for multiple product lines, including LTSS, Exchange, DSNP.
  • Lead negotiator of VBC in conjunction with AE.

Education/Experience:

  • Bachelor's Degree. Five or more years' experience if no Bachelor's Degree. Five or more years' experience if no Bachelor's Degree. Five or more years' experience if no Bachelor's Degree
  • 5 or more years experience if no Bachelor's Degree.
  • 3 or more years AE experience, Financial Acumen, Ability to have difficult conversations, 1+ year contract negotiation experience, Understanding of reimbursement methodologies to include risk or VB contracting.

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

Employment Type: FULL_TIME

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