Director, Network Development and Contracting

At VNS Health, we're transforming healthcare by building high-performing provider networks that deliver exceptional care and value to the communities we serve. We are seeking an experienced Director, Network Development & Contracting to lead the strategic development, expansion, and management of our physician, hospital, behavioral health, and ancillary provider networks across our Health Plan products. This leader will oversee provider contracting, network strategy, reimbursement negotiations, regulatory network adequacy, and value-based payment initiatives while ensuring alignment with organizational growth objectives and medical cost ratio (MCR) goals. The ideal candidate is a strategic negotiator, collaborative relationship builder, and experienced managed care leader with deep knowledge of provider contracting and network management.

What You Will Do

Strategic Network Development

• Lead the development and execution of provider network strategies that support product expansion, market growth, member access, and network adequacy requirements.
• Design and implement provider recruitment strategies based on product needs, specialty mix, geographic coverage, member benefits, and market opportunities.
• Identify opportunities to strengthen and optimize provider networks while supporting organizational quality, affordability, and growth objectives.

Provider Contracting & Negotiations

• Direct the negotiation and administration of contracts with physicians, hospitals, ancillary providers, behavioral health providers, Independent Physician Associations (IPAs), and group practices.
• Lead negotiations involving value-based payment arrangements, risk-based contracts, and innovative reimbursement models.
• Oversee the development, maintenance, and governance of provider contract templates across all lines of business.
• Provide leadership and oversight for contracting activities performed by internal staff and external consultants.

Network Performance & Compliance

• Monitor network adequacy, provider performance, utilization trends, member demand, and market dynamics to ensure compliance with CMS, New York State Department of Health (NYS DOH), and other regulatory requirements.
• Develop action plans to address network gaps and support service area or product expansions.
• Partner with Quality, Care Management, Utilization Management, and other Health Plan leaders to ensure provider performance supports quality outcomes and operational excellence.
• Recommend operational improvements and best practices that enhance provider performance, network efficiency, and member experience.

Leadership & Collaboration

• Build strong relationships with providers, health systems, community partners, and internal stakeholders.
• Collaborate with executive leadership to identify strategic network opportunities that improve quality, affordability, and access.
• Develop provider policies and procedures in partnership with cross-functional teams.
• Stay informed of industry trends, reimbursement methodologies, regulatory changes, and competitive market developments, providing recommendations to senior leadership.

People Leadership

• Lead, coach, and develop a high-performing contracting and network development team.
• Manage staffing, performance management, employee development, succession planning, budgeting, and resource allocation.
• Foster a culture of collaboration, accountability, continuous improvement, and exceptional customer service.

Education

• Bachelor's degree in Business Administration, Health Administration, Health Policy, or a related field, or equivalent combination of education and experience required.
• Master's degree (MBA, MHA, MPH, or related field) preferred.

Experience

• Minimum of 10 years of progressive healthcare experience.
• At least 8 years of managed care provider contracting experience.
• Minimum of 2 years of provider relations and/or behavioral health network experience.
• Demonstrated experience negotiating and administering provider contracts across multiple provider types, including physicians, hospitals, ancillary providers, behavioral health providers, and IPAs.
• Experience leading value-based payment initiatives and risk-based contracting preferred.
• Experience ensuring compliance with CMS, NYS DOH, and other applicable regulatory requirements.