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Healthcare Provider Network Contractor Jobs (NOW HIRING)

Imedica

Provider Network Contractor II

Saint Louis, MO · On-site

$70K - $120K/yr

We deliver personalized health care experiences and partner closely with providers to ensure ... Produces an affordable and predictable network for customers and business partners. Evaluates and ...

Abilis Health Plan

Provider Network Manager

Nashville, TN · On-site +1

$70K - $80K/yr

Five (5)+ years of experience in managed care, provider network development, provider relations, contracting, or a related healthcare field. * Prior experience with Medicare Advantage plans required;

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Healthcare Provider Network Contractor information

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$10

$31

$98

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

As of Sep 3, 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 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 the key skills and qualifications needed to thrive as a healthcare provider network contractor?

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 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.

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.

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 August 2026, with employment types broken down into 1% Locum Tenens, 2% As Needed, 66% Full Time, 16% Part Time, and 15% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $66,177 per year, or $31.8 per hour.

Network Contractor PNM

AmeriHealth Caritas Health Plan

Columbia, SC • On-site

Full-time

Medical, Retirement, PTO

Re-posted 12 days ago

AmeriHealth Caritas rating

8.3

Company rating: 8.3 out of 10

Based on 73 frontline employees who took The Breakroom Quiz

132nd of 315 rated insurance

Job description

Job Summary:
The Network Contractor is responsible for developing, contracting, and maintaining a high-quality provider network within established markets. This role supports network strategy through provider recruitment, contract negotiations, provider satisfaction initiatives, and network adequacy management. The Network Contractor collaborates with internal stakeholders to ensure provider agreements are compliant, cost-effective, and aligned with organizational goals.
Essential Responsibilities:
  • Support the execution of network development strategies.
  • Recruit and contract providers to address identified network adequacy gaps, including high-complexity provider types.
  • Negotiate provider contracts that align with organizational network objectives and reimbursement methodologies.
  • Negotiate Single Case Agreement (SCA) rates and convert SCA providers to fully contracted providers.
  • Augment and modify provider networks to support new products, programs, and clients.
  • Support contracting efforts across multiple lines of business, including:
    • Long-Term Services and Supports (LTSS)
    • Health Insurance Exchange Plans
    • Dual Eligible Special Needs Plans (D-SNP)
  • Lead provider contract negotiations to secure favorable contract terms.
  • Review contract language and collaborate with Legal partners to ensure contract integrity and compliance.
  • Ensure all provider agreements comply with federal and state regulations, policies, procedures, and organizational standards.
  • Support value-based care (VBC) contracting initiatives in partnership with Account Executives and other stakeholders.
  • Maintain compliance with annual contracting schedules and provider network requirements.
  • Assist leadership with activities related to provider satisfaction, education, and communication.
  • Support quality initiatives, including:
    • Healthcare Effectiveness Data and Information Set (HEDIS)
    • Consumer Assessment of Healthcare Providers and Systems (CAHPS)
    • National Committee for Quality Assurance (NCQA)
    • Utilization Review Accreditation Commission (URAC)
  • Serve as a subject matter expert (SME) on payment methodologies and fee schedules for complex provider specialties.
  • Provide support for provider-related operational issues, including:
    • Claims processing
    • Payment integrity
    • Provider data management
    • Credentialing
    • Appeals and dispute resolution

Work Arrangement:Remote; Field Based
  • Must reside in South Carolina. Will make provider visits throughout the state when necessary.

Education/Experience:
  • Bachelor's degree; OR Five (5) or more years of relevant healthcare provider network management, contracting, or provider relations experience in lieu of a bachelor's degree.
  • Three (3) or more years of Account Executive, provider contracting, or provider network management experience.
  • One (1) or more years of provider contract negotiation experience.
  • Experience negotiating reimbursement methodologies, risk-based contracts, or value-based care agreements.
  • Strong financial acumen and analytical skills.
  • Ability to effectively manage complex negotiations and challenging business conversations.
  • Knowledge of provider network development, healthcare operations, and managed care environments.

Preferred Knowledge, Skills & Abilities:
  • Provider network development and management
  • Contract negotiation and relationship management
  • Healthcare reimbursement methodologies
  • Value-based care contracting
  • Regulatory and compliance knowledge
  • Provider satisfaction and engagement
  • Financial analysis and contract evaluation
  • Claims and operational process knowledge
  • Strong communication, presentation, and collaboration skills
  • Project management and organizational skills

Our Comprehensive Benefits Package
We offer flexible work solutions, including remote options and hybrid schedules, competitive pay, paid time off (including holidays and volunteer events), health insurance coverage for you and your dependents starting Day 1, 401(k), tuition reimbursement, and more.
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 healthcare solutions, we offer our associates the opportunity to impact millions of lives through our national footprint of products, services, and award-winning programs. If you want to make a difference, we'd love to hear from you.
Headquartered in Newtown Square, PA, 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. Our offerings include integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us atwww.amerihealthcaritas.com

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