Provider Network Management Jobs
Provider Network Management jobs are open across health insurance, managed care, hospitals, and health systems, from coordinator to director level, with specializations in contracting, credentialing, and network development. Find a role that fits from the openings below and apply directly.
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Role Overview: The Director, Provider Network Management, is responsible for developing and executing the provider network strategy across all AmeriHealth Caritas New Hampshire lines of business. Reporting directly to the Market President and serving as a key member of the Executive Leadership Team, this leader will drive provider network performance, affordability, quality outcomes, population health initiatives, and provider satisfaction while strengthening AmeriHealth Caritas’ position as the preferred healthcare partner throughout New Hampshire.
Work Arrangements:
- Hybrid – Associate must be located in New Hampshire and work onsite at the Manchester, NH office three days per week.
Responsibilities:
- Drive market provider network development and network management strategies to support business growth, network adequacy, and member access across all lines of business.
- Develop and execute the annual provider network strategy, ensuring compliance with network adequacy requirements and establishing a competitive, marketable provider network.
- Lead initiatives to improve provider satisfaction while ensuring compliance with pricing guidelines established by AmeriHealth Caritas Health Plan (AHC) and Plan leadership.
- Monitor Single Case Agreement (SCA) trends and implement contracting strategies to reduce out-of-network utilization and improve network efficiency.
- Provide leadership, coaching, performance management, and staffing oversight for the Provider Network Management team, including hiring, annual evaluations, and development planning.
- Ensure departmental compliance with all federal and state regulations, accreditation standards, policies, and procedures; develop and revise departmental policies as needed.
- Partner closely with the Market Director of Quality to advance key quality initiatives and performance measures, including Healthcare Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Healthcare Providers and Systems (CAHPS), and National Committee for Quality Assurance (NCQA)/Utilization Review Accreditation Commission (URAC) standards.
- Review provider satisfaction survey results and lead the development and implementation of action plans to address opportunities for improvement and enhance the provider experience.
- Maintain accountability for the timely resolution of provider disputes, escalations, and contract-related concerns.
- Oversee provider network performance and access, ensuring adequate geographic coverage and appropriate availability of services throughout the health plan's service area.
- Bring strong operational knowledge related to provider satisfaction, provider education, and provider communications, with expertise in claims, payment integrity, provider data management, credentialing, appeals, and dispute resolution processes.
- Provide oversight for large-scale provider terminations and network disruption mitigation strategies.
- Ensure provider contracts align with approved reimbursement and claims payment methodologies.
- Manage non-standard contract provisions, ensuring appropriate tracking, communication, and required approvals from AHC and Plan leadership before provider submission.
- Lead complex negotiations with hospitals, health systems, physician groups, ancillary providers, and clinically integrated networks, including Value-Based Care (VBC) agreements and alternative payment models.
- Provide strategic oversight of all facility, physician, ancillary, and physician extender network development and management activities.
- Serve as the lead negotiator for high-impact provider agreements and Value-Based Care (VBC) arrangements as needed.
- Perform other duties and strategic initiatives as assigned.
Education & Experience:
- Bachelor’s degree in business or health-related disciplines, such as healthcare administration or healthcare management, and equivalent business experience is preferred.
- 3 years of experience in managed care provider contracting and reimbursement is required, including in-depth knowledge of reimbursement methodologies and contracting terms.
- 1 to 2 years of Medicaid experience is preferred.
- 8 to 10 years of progressive business management and negotiation experience is preferred.
- 5 years of management experience, managing teams, and project management is preferred.
- Demonstrated success across Medicaid, Medicare Advantage, D-SNP, and/or Exchange products.
- Strong financial, analytical, negotiation, and executive communication skills.
- Proven experience leading complex organizational and provider transformation initiatives.
Licensure:
- Valid driver’s license and current car insurance are required.
Skills & Abilities:
- Strong financial acumen with experience analyzing provider economics, reimbursement methodologies, health plan performance, and business impact.
- Advanced analytical capabilities with experience leveraging provider performance data, predictive analytics, business intelligence tools, and market intelligence to drive strategic decision-making.
- Outstanding negotiation and influencing skills with a proven track record leading complex facility, physician, and value-based contracting negotiations.
- Ability to develop and implement large-scale organizational change, provider transformation initiatives, and operating model enhancements.
- Strong understanding of provider operations, claims administration, payment integrity, credentialing, provider data management, appeals, grievances, and dispute resolution processes.
- Experience developing provider engagement, provider satisfaction, and provider communication strategies that improve provider experience and operational effectiveness.
- Excellent verbal, written, presentation, and executive communication skills with the ability to effectively engage boards, executive leadership, providers, and government stakeholders.
- Demonstrated ability to lead cross-functional teams, influence without direct authority, and build consensus across complex organizational environments.
- Strategic thinker with the ability to anticipate market trends, identify growth opportunities, and align provider strategy with organizational goals.
- Ability to balance quality outcomes, affordability, member experience, and provider satisfaction while driving measurable business results.
- Strong project management and organizational skills with the ability to manage multiple priorities in a fast-paced, highly regulated environment.
- Proficiency with healthcare analytics platforms, provider performance reporting tools, Microsoft Office Suite, and other healthcare technology solutions.
- Commitment to fostering a culture of accountability, collaboration, innovation, continuous improvement, and member-centered care.
Role Overview: The Director, Provider Network Management, is responsible for developing and executing the provider network strategy across all AmeriHealth Caritas New Hampshire lines of business. Reporting directly to the Market President and serving as a key member of the Executive Leadership Team, this leader will drive provider network performance, affordability, quality outcomes, population health initiatives, and provider satisfaction while strengthening AmeriHealth Caritas’ position as the preferred healthcare partner throughout New Hampshire.
Work Arrangements:
- Hybrid – Associate must be located in New Hampshire and work onsite at the Manchester, NH office three days per week.
Responsibilities:
- Drive market provider network development and network management strategies to support business growth, network adequacy, and member access across all lines of business.
- Develop and execute the annual provider network strategy, ensuring compliance with network adequacy requirements and establishing a competitive, marketable provider network.
- Lead initiatives to improve provider satisfaction while ensuring compliance with pricing guidelines established by AmeriHealth Caritas Health Plan (AHC) and Plan leadership.
- Monitor Single Case Agreement (SCA) trends and implement contracting strategies to reduce out-of-network utilization and improve network efficiency.
- Provide leadership, coaching, performance management, and staffing oversight for the Provider Network Management team, including hiring, annual evaluations, and development planning.
- Ensure departmental compliance with all federal and state regulations, accreditation standards, policies, and procedures; develop and revise departmental policies as needed.
- Partner closely with the Market Director of Quality to advance key quality initiatives and performance measures, including Healthcare Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Healthcare Providers and Systems (CAHPS), and National Committee for Quality Assurance (NCQA)/Utilization Review Accreditation Commission (URAC) standards.
- Review provider satisfaction survey results and lead the development and implementation of action plans to address opportunities for improvement and enhance the provider experience.
- Maintain accountability for the timely resolution of provider disputes, escalations, and contract-related concerns.
- Oversee provider network performance and access, ensuring adequate geographic coverage and appropriate availability of services throughout the health plan's service area.
- Bring strong operational knowledge related to provider satisfaction, provider education, and provider communications, with expertise in claims, payment integrity, provider data management, credentialing, appeals, and dispute resolution processes.
- Provide oversight for large-scale provider terminations and network disruption mitigation strategies.
- Ensure provider contracts align with approved reimbursement and claims payment methodologies.
- Manage non-standard contract provisions, ensuring appropriate tracking, communication, and required approvals from AHC and Plan leadership before provider submission.
- Lead complex negotiations with hospitals, health systems, physician groups, ancillary providers, and clinically integrated networks, including Value-Based Care (VBC) agreements and alternative payment models.
- Provide strategic oversight of all facility, physician, ancillary, and physician extender network development and management activities.
- Serve as the lead negotiator for high-impact provider agreements and Value-Based Care (VBC) arrangements as needed.
- Perform other duties and strategic initiatives as assigned.
Education & Experience:
- Bachelor’s degree in business or health-related disciplines, such as healthcare administration or healthcare management, and equivalent business experience is preferred.
- 3 years of experience in managed care provider contracting and reimbursement is required, including in-depth knowledge of reimbursement methodologies and contracting terms.
- 1 to 2 years of Medicaid experience is preferred.
- 8 to 10 years of progressive business management and negotiation experience is preferred.
- 5 years of management experience, managing teams, and project management is preferred.
- Demonstrated success across Medicaid, Medicare Advantage, D-SNP, and/or Exchange products.
- Strong financial, analytical, negotiation, and executive communication skills.
- Proven experience leading complex organizational and provider transformation initiatives.
Licensure:
- Valid driver’s license and current car insurance are required.
Skills & Abilities:
- Strong financial acumen with experience analyzing provider economics, reimbursement methodologies, health plan performance, and business impact.
- Advanced analytical capabilities with experience leveraging provider performance data, predictive analytics, business intelligence tools, and market intelligence to drive strategic decision-making.
- Outstanding negotiation and influencing skills with a proven track record leading complex facility, physician, and value-based contracting negotiations.
- Ability to develop and implement large-scale organizational change, provider transformation initiatives, and operating model enhancements.
- Strong understanding of provider operations, claims administration, payment integrity, credentialing, provider data management, appeals, grievances, and dispute resolution processes.
- Experience developing provider engagement, provider satisfaction, and provider communication strategies that improve provider experience and operational effectiveness.
- Excellent verbal, written, presentation, and executive communication skills with the ability to effectively engage boards, executive leadership, providers, and government stakeholders.
- Demonstrated ability to lead cross-functional teams, influence without direct authority, and build consensus across complex organizational environments.
- Strategic thinker with the ability to anticipate market trends, identify growth opportunities, and align provider strategy with organizational goals.
- Ability to balance quality outcomes, affordability, member experience, and provider satisfaction while driving measurable business results.
- Strong project management and organizational skills with the ability to manage multiple priorities in a fast-paced, highly regulated environment.
- Proficiency with healthcare analytics platforms, provider performance reporting tools, Microsoft Office Suite, and other healthcare technology solutions.
- Commitment to fostering a culture of accountability, collaboration, innovation, continuous improvement, and member-centered care.
Provider Network Management Jobs by Experience Level
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Find JobsProvider Network Management Job Market
Who's Hiring
Top Industries Hiring
- Insurance
What Employers Look For
The qualifications that appear most often in provider network management jobs.
- 3-5 years of experience in provider contracting, credentialing, or network development
- Knowledge of fee schedule development, reimbursement methodologies, and value-based contract structures
- Proficiency with credentialing platforms such as CAQH ProView or equivalent systems
- Familiarity with network adequacy standards set by CMS, state regulators, or accreditation bodies
- Bachelor's degree in healthcare administration, business, or a related field
- Experience with provider data management systems and maintaining accurate provider directories
Tips for Your Provider Network Management Job Search
Tailor your resume to contract language
Hiring managers in provider network management look for fluency in fee schedules, value-based arrangements, and network adequacy standards. Name the specific contract types you've negotiated or reviewed rather than listing generic relationship management skills.
Apply early to roles that fit
Migrate Mate lists provider network management openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Highlight credentialing software you know
Employers routinely screen for hands-on experience with tools like CAQH ProView, Navicure, or similar credentialing platforms. If you've used any, call them out in your skills section by exact product name, not just 'credentialing software.'
Target openings by payer type strategically
Your background in commercial, Medicaid, or Medicare Advantage networks is not interchangeable to most employers. Search by payer segment and align your application materials to the regulatory and contracting nuances specific to that line of business.
Prepare case studies around network gaps
Interviewers frequently ask how you've addressed network adequacy deficiencies or recruited hard-to-fill specialties. Walk in with a specific example that covers how you identified the gap, your outreach approach, and the outcome in terms of access or compliance.
Negotiate using access compliance as leverage
When discussing offers, frame your value around regulatory risk reduction, not just headcount managed. Demonstrating you understand CMS or state network adequacy standards positions you as a strategic hire and supports a stronger compensation conversation.
Provider Network Management Jobs: Frequently Asked Questions
Which companies are hiring the most provider network managements?
The companies hiring the most provider network managements right now include AmeriHealth Caritas, Oscar Health, and Scripps Health, with the largest share of openings in Idaho, New York, and Indiana, based on current listings on Migrate Mate as of August 2026. Health plans, managed care organizations, and large hospital systems consistently represent the largest share of open roles.
How many provider network management jobs are remote?
About 100% of provider network management openings are fully remote or hybrid as of August 2026, reflecting the administrative nature of much of the work. Credentialing coordination and provider relations roles tend to be the most remote-friendly, while contracting positions that involve in-person provider negotiations are more likely to require on-site or travel-based work.
How do you become a provider network management?
Start with a bachelor's degree in healthcare administration, business, or a related field, then build foundational experience in healthcare operations, provider relations, or managed care. Develop fluency in provider contracting, credentialing workflows, and network adequacy requirements. Earning a credential such as the Certified Provider Credentialing Specialist designation strengthens your candidacy for mid-level and senior roles.
Can you get a provider network management job with little experience?
Entry-level roles exist in provider relations, credentialing coordination, and network operations support, and these are the most practical starting points with limited experience. Employers hiring at this level look for healthcare administration coursework, familiarity with insurance terminology, and demonstrated comfort working in compliance-driven environments. Internships or administrative roles at a health plan or hospital accelerate the path considerably.
What does the provider network management interview process look like?
Most processes run two to three rounds. An initial screening with a recruiter or HR contact focuses on your background in contracting or credentialing. A second interview with a network director or VP typically includes scenario-based questions about resolving network adequacy deficiencies, handling difficult provider negotiations, or managing a high-volume credentialing caseload. Some employers add a brief written exercise or case study at this stage.
Where can I find and apply to provider network management jobs?
You can find and apply to provider network management jobs on Migrate Mate, which lists current openings from across the United States in one place. Search for roles that match your background in contracting, credentialing, or network development, and apply directly to each listing that fits.
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