Director of Contracting

Requisition: 2026-197166 Director of Contracting Job Locations US-KY-LOUISVILLE | US-OH-CLEVELAND | US-TN-NASHVILLE | US-TX-DALLAS ID 2026-197166 Line of Business Abilis Health Plan Position Type Full-Time Pay Min USD $130,000.00/Yr. Pay Max USD $150,000.00/Yr. Our Company Abilis Health Plan Overview The Dir of Contracting & Network Management is a leadership role responsible for developing, negotiating, and managing provider contracts and networks for the health plan. This leader ensures that provider networks are adequate, efficient, financially sustainable, and aligned with the organization's strategic goals (e.g., value-based care, member access, cost containment). The role combines strategy, operations, regulatory compliance, provider relationships, analytics, and financial oversight. Responsibilities Key Responsibilities Network Strategy & Design * Develop, lead and execute provider network strategies to ensure sufficient access across specialties and geographies. * Evaluate market trends, competitor networks, member needs, and regulatory requirements. * Identify network adequacy gaps (geographic, specialty, quality) and develop plans to close them. Contracting & Negotiations * Negotiate contracts with hospitals, physician groups, ancillary providers, and facility partners. * Manage contract lifecycle: drafting, reviewing, executing, renewing, amending, termination. * Structure payment/reimbursement models, including fee for service, capitation, bundled payments, shared savings, etc. * Ensure terms in contracts align with financial targets, risk tolerances, quality goals, and regulatory obligations. Provider Relations & Network Management * Maintain and strengthen relationships with providers; serve as point of escalation for issues. * Oversee provider data integrity, delegation oversight, and provider performance. * Facilitate provider satisfaction, addressing service or payment concerns. * Support provider onboarding, education around contract terms, and performance expectations. Operational Oversight & Compliance * Lead operational functions such as network administration, provider directory maintenance, delegation oversight. * Ensure network adequacy meets federal/state regulatory requirements. * Oversee policies, procedures, and systems to track and govern contracting and network operations. * Coordinate with legal, finance, compliance, claims, member services, and other stakeholders. Value-Based Care & Cost Management * Lead or support the development of value based contracting models * Work with analytics team to develop monitoring for utilization, cost trends, provider performance, and identify improvement opportunities. * Develop reimbursement strategies that balance cost, access, quality, and provider incentives. Financial Management & Analytics * Develop and manage budgets for network and contracting functions. * Forecast network costs, provider reimbursements; assess financial impacts of different contracting strategies. * Monitor medical loss ratio (MLR) and other cost drivers associated with provider contracts. Leadership & Team Management * Build, lead, men