Director, Provider Contracting @ Gravie

Favorable new network contracts - Own the end-to-end contracting process for new markets, delivering signed, competitively priced agreements with providers, facilities, and vendors

Provider overpayment recoupment - Own the recoupment function end to end: set provider outreach strategy, decide resolution on contested recoupments (where contract and rate interpretation usually decide the outcome), and manage the interface with Claims on identification and processing and with Finance on recovery tracking

Network delegation management - Own the performance, compliance, and oversight of delegated entities (e.g., credentialing, repricing, utilization management), including audits and corrective action plans

Product & tech lead - Serve as the network team's lead partner to Product and Engineering, shaping requirements for contracting, provider data, and network configuration systems

Key Result: New network launches - Success in this role is measured by our ability to launch new provider networks on time, in compliance, and at target cost

Lead design and negotiation of value-based care arrangements - shared savings, risk-based, and bundled payment models - with health systems and provider groups

Independently draft, negotiate, and finalize complex provider and vendor contracts, delegation agreements, and amendments, securing terms that support Gravie's growth into new markets

Own new network contracts and launches, acting as the accountable lead for building compliant, competitively priced networks in new geographies

Manage network delegation relationships end-to-end, including delegate oversight, audits, and performance management

Ensure all contracts and network operations meet CMS, state DOI, and network adequacy requirements across every market we operate in

Act as the product and tech lead for the network team, partnering with Product and Engineering to improve contracting workflows, provider data management, and configuration tooling

Partner with Finance and Actuarial to build and refine reimbursement strategy across fee-for-service, value-based, bundled payment, and capitation models

Analyze network adequacy and market dynamics to identify expansion opportunities and recruitment priorities

Serve as the senior escalation point for provider and vendor contract disputes

Track industry trends and competitor positioning to keep Gravie's contracting strategy ahead of the market

Partner with executive leadership on network strategy, budgeting, and cost-containment initiatives

Bachelor's degree, or equivalent experience, and 8+ years of experience in provider contracting, network management, or healthcare reimbursement

5+ years of experience negotiating value-based care arrangements, including risk-based and shared savings models

5+ years of experience independently drafting and negotiating complex healthcare contracts and delegation agreements

5+ years of experience leading network contracting strategy and managing relationships with providers, facilities, or vendors

3+ years of experience managing delegated entities, including delegate oversight, audits, and compliance

4+ years of experience ensuring contracts and network operations comply with CMS and state insurance regulations

2+ years of experience partnering with Product or Engineering teams to shape systems or tooling requirements

Proven track record leading new network builds or market launches from contracting through go-live

Experience launching provider networks in new geographies or markets

Experience at a small or mid-sized health plan where cross-functional collaboration is a must

Familiarity with contracting or network configuration systems and how they're built or improved

Previous startup company experience

Project or program management experience

We know healthcare. Our company was founded and is still led by industry veterans who have started and grown several market-leading companies in the space.

We have raised money from top tier investors who share the same long-term vision as we do of building an industry defining company that will endure over the long run. We are well capitalized.

Our clients love us. Customer satisfaction rates among employees using Gravie health plans consistently rank above 80% – nearly 40 points above the industry average.

Our culture is unique. We tend to be non-hierarchical, merit-driven, opinionated but kind people who thrive working in a high-performance, fast-paced environment. People at Gravie care deeply about making a positive impact in the lives of the people we serve.