AVP, Contracting & Network Management

Overview

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most. The company’s mission is to put senior care first and provide innovative, high‑quality, low‑cost solutions. The AVP, Contracting & Network Management reports to the National SVP, Network Strategy & Market Development.

In this role the AVP will develop network strategies and manage the implementation of network development and network management plans. The goal is to create health‑care delivery systems that support marketability, member and provider satisfaction, and overall company success.

• Create, translate, and execute strategies for optimal network development in established and new markets.
• Lead, manage, negotiate and implement all types of provider network contracts, including IPAs/Medical Groups, hospitals, direct‑network physicians, ancillary providers, and supplemental vendors.
• Develop strategic approaches to generate value from next‑generation contracting, network design, and care models for government‑sponsored populations.
• Utilize financial models to develop and execute reimbursement strategies, including capitation, per‑diems, case rates, value‑based arrangements, and incentive programs to improve quality and efficiency.
• Provide network contracting analysis and expert contract language support for net‑working needs across markets.
• Leverage the competitive landscape to assess and design network and contracting strategies.
• Collaborate with multidisciplinary teams to achieve desired growth, financial, and operational outcomes.
• Build and sustain strong relationships with key stakeholders, physician leaders, and delivery systems.
• Work with providers and delivery systems in new and emerging markets to maximize successful market launches and implementations.
• Direct others to resolve highly complex or unusual business issues affecting significant functions or disciplines.
• Identify, evaluate, and implement network performance opportunities and development activities to support continuous improvement.
• Collaborate with Regional Medical Officers, Market Presidents, and other department heads to ensure overall market success.
• Meet and exceed budgeted operating goals.
• Establish department metrics and set clear expectations for staff and market performance.
• Support training and onboarding of new market network leaders to promote adoption of best practices.

• Oversee staff that supports the network management needs of the markets.
• Recruit, select, orient, and train employees.
• Assign workloads, monitor performance, and appraise job results.
• Coach, counsel, and discipline employees when necessary.

• 10 years of experience in managed care or health care, or an equivalent combination of education and experience.
• Strong understanding of reimbursement methodologies, contract language, negotiation strategies, financial modeling and analysis, and managed care/Merit Advantage plans.
• BA/BS required; MBA strongly preferred.
• Proven network management and contracting expertise.
• Excellent analytical and critical‑thinking skills.
• Strong leadership and people‑management abilities.
• Excellent oral, written, and presentation skills, with the ability to convey complex information clearly.
• Proficiency in Microsoft Office (Word, Excel) and experience with both delegated and non‑delegated providers.
• Experience managing medical cost through network strategies.
• Ability to travel nationally up to 50% of the time and work evenings, weekends, and extended hours as needed.
• Outstanding organizational and project‑management abilities.
• Strong facilitation and presentation skills.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.