Specialist, Network Development

Network Development Specialist

At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!

JOB SUMMARY

The Network Development Specialist is responsible for identifying and evaluating opportunities in support of Claritev’s Network-Based Solutions by negotiating optimal reimbursement rates and drafting contracts for network and non-network providers supporting commercial and government products. This role helps ensure patient access to high-quality, cost-effective healthcare providers while supporting network adequacy requirements, client expectations, and company objectives.

This position requires strong relationship management, negotiation, communication, and analytical skills. The ideal candidate will be comfortable managing provider relationships, analyzing market trends, negotiating contract terms, and working collaboratively across teams in a fast-paced environment.

DUTIES

1. Negotiate provider contracts to support penetration, discount, and network adequacy objectives aligned with regional and national goals.
2. Identify and recruit providers to support federal, state, and local Network Adequacy standards for government and commercial clients.
3. Foster and maintain strong provider relationships, including day-to-day management of assigned provider accounts and resolution of escalated issues.
4. Maintain and exceed contracting production and quality standards consistent with established goals.
5. Prepare analyses, reports, and presentations by collecting, analyzing, and summarizing information and market trends.
6. Partner with internal teams to conduct financial analyses and monitor market trends to support competitive reimbursement strategies.
7. Support Sales and Account Management teams by responding to access requirements, RFPs, SOWs, and other business opportunities related to network competitiveness and adequacy.
8. Ensure compliance with company policies, procedures, HIPAA regulations, and applicable regulatory requirements.
9. Collaborate, coordinate, and communicate effectively across departments and organizational levels.
10. Demonstrate commitment to Claritev’s core competencies and values.
11. Please note due to the exposure of PHI sensitive data, this role is considered to be a High Risk Role.
12. The position responsibilities outlined above are not all encompassing. Additional duties may be assigned as needed.

JOB SCOPE

The incumbent works under general supervision and applies foundational knowledge of principles, practices, and procedures related to provider network contracting and maintenance. This position is considered an entry-level role within the Provider Contracting job family.

The incumbent follows established procedures and collaborates with leadership when approval is needed outside standard guidelines. More complex issues are escalated for resolution as appropriate. The work is varied and may involve moderately complex situations requiring evaluation, problem-solving, and the ability to recommend solutions.

This role may partner with more experienced Provider Contractors on projects and team-based initiatives. The position may require overnight travel to meet with providers within assigned geographic territories and attend company-sponsored meetings or events.

The incumbent will continue developing the skills necessary to negotiate complex financial rate structures and contract language, while supporting successful provider recruitment and negotiations across Claritev’s commercial and government networks.

COMPENSATION

The salary range for this position is $65,000 - $73,000. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

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