Director, Provider Contracting @ Gravie

Hi, we’re Gravie. Our mission is to create health benefits that actually benefit small and midsize businesses and their employees. Our innovative benefit solutions and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way. We're looking for an experienced contracting expert to own the provider contracting strategy for Gravie's health plan. This is a senior, strategic role: you'll lead value-based care contracting, write and negotiate our most complex network agreements, manage our network delegation relationships, and serve as the product/tech lead for our contracting and network systems. You'll also be the accountable owner for standing up new provider networks as Gravie expands into new markets - your work directly enables new network launches. This role reports into network leadership and works closely with Finance, Actuarial, Compliance, Product, and Engineering to build a network strategy that scales with the business. CORE ACCOUNTABILITIES: - 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 YOU WILL: - 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 YOU BRING: - 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 EXTRA CREDIT: - 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 A LITTLE MORE ABOUT US: - 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. BENEFITS Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard health and wellness benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paid parental leave, paid holidays, a 401k program, transportation perks, education reimbursement, and 2 days of paid paw-ternity leave.