JOB OVERVIEW

The Network Development Manager is responsible for building, contracting, and maintaining a high-performing provider network that supports the growth and quality objectives of the Medicare Advantage (MA) Plan. This role requires a strong understanding of Medicare Advantage regulations, provider contracting, reimbursement methodologies, and relationship management. The Manager will lead efforts to expand provider networks, ensure compliance with CMS access requirements, negotiate provider agreements, and foster strong partnerships that drive member satisfaction and plan performance.

EDUCATION & EXPERIENCE

• 5+ years of provider network development, contracting, or related experience, preferably in Medicare Advantage
• Strong understanding of Medicare Advantage regulations, CMS network adequacy standards, and value-based contracting.
• Proven experience negotiating provider agreements with physicians, hospitals, and ancillary providers.

SKILLS & COMPETENCIES

• Excellent negotiation, communication, and relationship management skills.
• Strong analytical ability with experience in provider reimbursement methodologies (FFS, capitation, shared savings, risk models).
• Ability to manage multiple priorities in a fast-paced, highly regulated environment.
• Proficiency in Microsoft Office and provider network management systems.