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CareSource

Member-first health plan: Marketplace, Medicare, Medicaid

Network Strategy Director

Business OperationsConfirmed live in the last 24 hours
Full-timeRemote in USA

About the Job

Requirements

  • A bachelor's degree in a business-related field is required, although equivalent years of relevant work experience may be accepted in lieu of the required education.
  • Eight years of provider contracting experience are required, including a demonstrated track record of independently leading complex, high-dollar, multi-stakeholder negotiations.
  • Expert-level knowledge of reimbursement methodology and contract law fundamentals is required.
  • Ability to design and defend novel contract structures is required.
  • Sophisticated financial and risk analysis skills are required.
  • Expert-level negotiation and deal architecture skills are required.
  • Enterprise strategic thinking is required.
  • Executive presence and provider-facing credibility are required.
  • Mentorship and technical leadership without formal authority are required.
  • Complex risk and financial structuring skills are required.

Responsibilities

  • Lead negotiations for the organization's largest and most strategically significant provider agreements, including major health systems, multi-market integrated delivery networks, and national durable medical equipment vendor contracts, often representing eight-figure annual spend.
  • Serve as the enterprise subject-matter expert on contracting strategy, reimbursement methodology, and deal structuring, and advise leadership on negotiation approaches for the highest-stakes deals.
  • Design and pilot novel contract structures, including advanced value-based care arrangements, risk corridors, and performance-based rate mechanisms, ahead of broader rollout.
  • Mentor contracting professionals enterprise-wide on negotiation techniques, deal structuring, and complex contracting methodologies.
  • Partner cross-functionally to resolve complex contractual, financial, and regulatory issues arising during negotiations.
  • Represent National Network Development in executive-level provider discussions and market-facing negotiations requiring senior credibility.
  • Own strategic renewal planning for the highest-exposure agreements in the renewal pipeline across 90-, 180-, and 365-day windows.
  • Contribute contracting expertise to enterprise initiatives, including new market entry readiness, network optimization pilots, and value-based care expansion strategy.
  • Perform other job-related duties as requested.

Desired Qualifications

  • A master's degree in a business-related field is preferred.
  • Direct experience negotiating with major health systems or integrated delivery networks is preferred.
  • Experience designing value-based or risk-based contract structures is preferred.

About the Company

CareSource

Member-first health plan: Marketplace, Medicare, Medicaid

CareSource provides health coverage to more than 2 million members, offering Marketplace plans as well as Medicare and Medicaid products. Its core service is delivering health insurance and related care to individuals and communities through a member-first approach, aiming to improve health and well-being over time. The company operates with a focus on affordable, accessible coverage and care coordination across states, guided by its mission to place people over profits rather than simply selling plans. Key differentiators include a long history (30+ years), a national footprint with 4,500+ employees, and an emphasis on serving members’ needs and languages while promoting equal opportunity employment. The overarching goal is to help members live healthier lives by providing comprehensive coverage and support.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Dayton, OH
Founded
1989

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