Head of Provider Network Development
Core
Lead strategic provider sourcing to expand and improve the payer network by recruiting non-anchor providers, Essential Community Providers (ECPs), and Federally Qualified Health Centers (FQHCs) to meet network adequacy standards and improve patient access.
Role type
Senior leadership, provider network development
Builds
A compliant provider network enabling profitable member growth
Domain
Health insurance / Provider network management
Required skills
Strategic network expansion planning, regulatory compliance (CMS/state standards), team leadership and mentorship, stakeholder management across contracting/legal/operations, network design analytics, CRM and network management platform proficiency
Preferred skills
Master's degree in Health Administration, Public Health, or Business Administration
Technologies
Quest Analytics, CRM tools
Responsibilities
Architect targeted network expansion strategies for non-anchor practitioners and community health centers; Monitor regional provider density and access metrics to close gaps; Partner with Network Contracting and Market Leadership to align recruitment with growth plans; Track recruitment pipeline velocity and team productivity; Use network design analytics to address regulatory coverage gaps; Build and lead a high-performing team of network development professionals
Seniority
Senior, hands-on IC with leadership responsibilities