Director of Network Strategy and Performance - Remote - Rhode Island

Primary Responsibilities

• Lead development and execution of Rhode Island DSNP/Medicaid network strategy
• Identify network gaps and prioritize provider recruitment, expansion, and growth opportunities
• Align market strategy with enterprise network direction while ensuring local competitiveness
• Ensure compliance with federal and state network adequacy standards (e.g., time/distance, provider ratios)
• Lead audit readiness, regulatory submissions, and RFP-related network performance
• Serve as the accountable market leader for network compliance and access outcomes
• Monitor network performance across access, quality, cost, and provider experience
• Drive action plans to address network gaps, provider access issues, and performance risks
• Partner with enterprise teams to advance value-based and performance-driven strategies
• Partner with UHN and contracting teams to influence provider recruitment and network build priorities
• Guide contracting strategy by translating Rhode Island market needs into actionable priorities
• Ensure alignment between enterprise execution and local network strategy
• Lead provider experience and engagement strategy to improve satisfaction and ease of doing business
• Identify and address provider friction points and escalation trends
• Strengthen provider advocacy and support models in partnership with enterprise teams
• Lead network-related initiatives across health plan, clinical, compliance, and enterprise partners
• Support DSNP growth strategy and market expansion efforts
• Ensure a competitive, locally differentiated network aligned to Rhode Island market needs

Required Qualifications

• 8+ years of healthcare experience, including provider network management
• 5+ years of leadership experience in a matrixed organization
• Experience leading complex, cross-functional initiatives
• Medicaid and/or DSNP programs experience
• Provider network strategy and performance experience
• CMS and state regulatory requirements experience
• Experience working in a model partnering with enterprise network/contracting teams (UHN/PROS)
• Experience supporting RFPs, network builds, or new market expansion
• Experience with Rhode Island Medicaid and/or DSNP programs
• Experience in value-based care or provider performance management

Preferred Qualifications

• Experience working in a model partnering with enterprise network/contracting teams (UHN/PROS)
• Experience supporting RFPs, network builds, or new market expansion
• Experience with Rhode Island Medicaid and/or DSNP programs
• Experience in value-based care or provider performance management

Pay

The salary for this role will range from $134,600 - $230,800 annually based on full-time employment.