Provider Network Strategy Specialist

About the role

The Provider Network Strategy Specialist is responsible for analyzing, developing, and executing network development strategies to support the growth and optimization of the organization’s Value-Based Care (VBC) provider network. This role plays a key part in identifying network gaps, evaluating provider opportunities, and driving strategic recruitment initiatives aligned with organizational and market objectives.

Responsibilities

• Analyze network composition, performance, and market dynamics to identify gaps, risks, and strategic growth opportunities
• Develop and execute targeted provider recruitment strategies aligned with value-based care goals and organizational priorities
• Evaluate prospective providers and organizations using defined and judgment-based criteria, including quality performance, capacity, and strategic alignment
• Exercise discretion in prioritizing recruitment efforts and managing a portfolio of provider opportunities based on business impact
• Lead coordination of provider contracting activities, ensuring alignment with network strategy and organizational objectives
• Review and assess provider agreements and documentation for alignment with business, operational, and regulatory standards
• Support negotiation discussions by identifying key issues, risks, and considerations, and recommending appropriate approaches
• Partner with internal stakeholders to facilitate timely execution and implementation of provider agreements
• Serve as a primary point of contact for prospective providers, guiding them through recruitment and onboarding processes
• Conduct in-person and virtual meetings with physicians, provider groups, and healthcare organizations to present network opportunities and influence participation decisions
• Identify and recommend improvements to provider engagement strategies and onboarding experiences
• Build and maintain relationships with key provider stakeholders to support long-term network development
• Act as a liaison between Value-Based Care, Business Development, Operations, Credentialing, and other internal teams
• Provide insights and recommendations to leadership to inform network development strategies and operational improvements
• Collaborate with leadership to align network activities with broader market and organizational goals
• Analyze provider pipeline, recruitment progress, and network performance data to inform strategic decision-making
• Maintain oversight of network development tracking tools and ensure data integrity for reporting purposes
• Prepare and present summaries, insights, and recommendations to leadership regarding network growth and performance
• Identify trends and opportunities to improve network development strategies and operational efficiency

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required
• 3+ years of experience in provider network development, healthcare operations, managed care, or related field
• Experience in provider relations, contracting, or network development preferred
• Demonstrated experience analyzing data and making recommendations that impact business or operational outcomes
• Valid driver’s license with ability to travel within the service area
• Demonstrated ability to exercise independent judgment and discretion in evaluating provider opportunities and network needs
• Strong analytical skills with the ability to interpret data and translate findings into actionable strategies
• Understanding of provider network development, healthcare contracting, and value-based care models
• Knowledge of CMS, Medicare, and Medicaid regulatory requirements
• Strong communication and presentation skills
• Ability to manage multiple priorities and adapt in a fast-paced environment
• Proficiency in Microsoft Office and data/reporting tools