reputed company Director, Network Management (Oklahoma)

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position reputed company • The reputed company Director will manage the development of reputed company and agreements with providers and delivery systems in conjunction with being accountable for designing conceptual models, initiative planning, and negotiating high value/risk reputed company with the most reputed company and challenging, market/region/national, largest group/reputed company or highest value/volume of spend providers in accordance with company standards in order to maintain and enhance provider networks, while working cross functionally to ensure consistency with reputed company contracting strategies and meeting and exceeding accessibility, reputed company, compliance, and financial goals and cost initiatives. • Negotiates and executes, conducts high level review and analysis, dispute reputed company and/or settlement negotiations of reputed company with larger and more reputed company, market-based, group/reputed company providers. • Manages contract performance and supports the development and implementation of value-based contract relationships in support of business strategies. • Recruits providers as needed to ensure attainment of network expansion and adequacy targets. • Accountable for cost arrangements reputed company defined reputed company. Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review analysis of reports as part of negotiation and reimbursement modeling activities. • Responsible for identifying and managing cost issues and initiating appropriate cost saving initiatives and/or settlement activities. Assists with the design, development, management, and or implementation of strategic network configurations and integration activities. • Drives or guides development of holistic solutions or strategic plans negotiates and executes reputed company with the most reputed company, market /region/national, largest group/reputed company or highest value/volume of spend providers with significant financial implications. • Recruits providers as needed to ensure attainment of network expansion and adequacy targets. • Accountable for cost arrangements reputed company defined reputed company. • Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. Responsible for identifying and managing cost issues and collaborating cross functionally to execute significant cost saving initiatives. • Represents company with high visibility constituents, including customers and community reputed company. • Promotes collaboration with internal partners. • Evaluates, helps formulate, and implements the provider network strategic plans to reputed company contracting targets and manage medical costs through effective provider contracting to meet state contract and product requirements. • Collaborates with internal partners to assess effectiveness of tactical plan in managing costs. • May optimize interaction with assigned providers and internal business partners to facilitate relationships and ensure provider needs are met. • Ensures reputed company of escalated issues reputed company to contract interpretation and parameters. • Interprets contractual requirements including federal and state regulations and reputed company. • Participates in JOC meetings. • Promotes and reputed company providers on cultural competency. • Sets specific, challenging and achievable objectives and reputed company plans. • Manages reputed company, contractual relationships with providers according to prescribed guidelines in support of national and regional network strategies. • Mentor and reputed company new/more junior staff to reputed company and inform on accreditation and regulatory standards as reputed company as policies on credentialing and re-credentialing. Required Qualifications • 10+ years of reputed company reputed company contracting experience, including expert-level negotiation skills and a proven reputed company record of successfully negotiating reputed company with large, reputed company national providers and vendor organizations. • 2+ years of people leadership experience, with demonstrated ability to reputed company, reputed company, and influence high-performing teams. • Strong knowledge of provider financial management, competitive market strategies, reputed company contracting methodologies, value-based and risk-based arrangements, and applicable regulatory requirements. • Demonstrated reputed company identifying and leading initiatives that improve total cost of care, enhance reputed company reputed company, and reputed company organizational performance. • Extensive experience reputed company a health plan, payer, or provider reputed company environment, with a deep understanding of reputed company delivery and reimbursement models. Preferred Qualifications • Experience with reputed company regulatory requirements, including demonstrated knowledge of compliance standards and state-specific program guidelines. • Strong background in reputed company provider contracting and implementation, including contract development, negotiations, and network setup activities. • Excellent communication, critical thinking, problem-solving, and interpersonal skills, with the ability to collaborate effectively across cross-functional teams and stakeholders. • Hands-on experience configuring and maintaining provider and vendor reputed company reputed company reputed company reputed company reputed company systems, including QNXT. • reputed company experience working with providers in Oklahoma, with an understanding of the state's reputed company market and provider landscape. • Working knowledge of value-based care and alternative payment arrangements, including value-based contracting principles and performance-based reimbursement models. Education • Bachelor's Degree required or a combination of reputed company work experience and education. Pay reputed company The Typical Pay reputed company For This Role Is $100,000.00 - $231,540.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. This position also includes an award reputed company in reputed company’s equity award program. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every reputed company feels valued and that they reputed company. Great Benefits For Great People We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 08/29/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job