Director Provider Contracting & Relations

How You Will Contribute Provider Contracting Strategy & Negotiation Lead development and execution of provider contracting strategies across markets and provider types, balancing cost, access, quality, network competitiveness, and long-term sustainability.Lead and support complex, high-impact negotiations with health systems and other provider partners, including contract renewals, reimbursement arrangements, amendments, new market opportunities, and escalated contractual issues.Develop negotiation strategies, objectives, financial parameters, and trade-off scenarios using market intelligence, contract performance, utilization trends, and organizational priorities.Evaluate reimbursement methodologies and contract terms, including fee schedules, percent-of-charge arrangements, case rates, bundled arrangements, value-based models, and other alternative payment structures.Identify contractual, financial, operational, and relationship risks; develop recommendations and escalation strategies to support informed decision-making.Ensure executed agreements and negotiated terms are clearly documented, operationally feasible, and effectively transitioned to the teams responsible for implementation and ongoing administration. Provider Relationships & Network Performance Build and maintain productive, long-term relationships with provider executives, contracting leaders, and operational partners through transparency, credibility, and consistent follow-through.Serve as a senior point of escalation for complex provider relationship matters, balancing partnership objectives with The Alliances responsibility to employers and members.Monitor provider and contract performance using cost, utilization, access, market, and other available data; identify opportunities for renegotiation, intervention, or strategic development.Assess network gaps, provider opportunities, and market dynamics and recommend strategies that strengthen access, affordability, differentiation, and competitive position.Partner with providers to resolve systemic issues and improve the effectiveness of the provider relationship and member experience. Leadership & Team Development Lead, coach, and develop provider contracting and relations team members; establish clear expectations, decision rights, priorities, and accountability for results.Build team capability in negotiation, relationship management, reimbursement strategy, market analysis, project execution, and effective cross-functional partnership.Create scalable workflows, standards, documentation, and operating rhythms that support consistent contracting practices and effective management of the provider portfolio.Allocate team resources and priorities based on organizational strategy, market needs, contract cycles, and emerging provider opportunities or risks.Foster a collaborative, accountable, learning-oriented culture that supports sound judgment, continuous improvement, and strong internal and external relationships. Cross-Functional Strategy & Organizational Partnership Partner closely with Provider Relations leadership and colleagues across Analytics, Finance, Legal, Operations, Business Development/Employer Engagement, and other functions to develop and execute integrated provider strategies.Translate employer needs, market feedback, financial analysis, and network performance insights into actionable contracting and provider relationship priorities.Provide provider-market expertise and recommendations in organizational planning, product development, growth initiatives, and strategic decision-making.Communicate complex contracting issues, market dynamics, risks, and recommendations clearly to executive and senior leadership audiences.Ensure key stakeholders are appropriately engaged throughout contracting initiatives and understand decisions, dependencies, implementation requirements, and expected outcomes. Market Intelligence, Innovation & Growth Maintain a strong understanding of healthcare market trends, provider consolidation, reimbursement practices, regulatory developments, transparency requirements, and emerging payment and delivery models.Analyze external developments and competitive dynamics to anticipate potential impacts on The Alliances provider network and employer members.Identify and evaluate opportunities for new provider partnerships, market expansion, alternative contracting approaches, and solutions that improve healthcare value.Develop data-informed business cases and recommendations for contracting initiatives, provider strategies, and network investments. Operational Excellence, Projects & Vendor Oversight Lead complex provider-facing projects and contracting initiatives from strategy and planning through negotiation, implementation, and transition to ongoing ownership.Establish project objectives, milestones, stakeholder roles, decision points, risks, and communication expectations for major contracting initiatives.Evaluate and oversee vendors or external partners supporting contracting, network operations, data, or provider-facing work; monitor service, value, and performance.Champion effective use of systems, data, templates, tools, and process improvements that increase contracting discipline, visibility, efficiency, and scalability.Maintain appropriate documentation and support compliance with organizational policies, contractual obligations, and applicable regulatory requirements.