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 Alliance’s 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 Alliance’s 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.