VP, Provider Network

Hiring a VP Provider Network with Medicare Advantage network experience , specifically building and managing Medicare Advantage provider networks in Mississippi and Oklahoma. Someone who can hold signing authority, build a network from the ground up in specific states, and manage TPA/MCO relationships.

Location:

100% remote in USA only

Industry:

healthcare solutions, delivering integrated services across the Medicare Advantage insurance markets.

Company Size :

small, startup style (under 60 people)

Compensation:

$200,000-250,000 Base DOE + Discretionary yearly bonus & benefits Reports to: President/CEO Position Overview Our client is seeking a seasoned and strategic VP, Provider Network to lead the development, expansion, and management of our provider and vendor network across the MA Plan space in Mississippi and Oklahoma . This executive-level role carries full contracting authority and serves as the primary relationship owner for our national provider and TPA/vendor partnerships. The VP, Provider Network will report directly to senior leadership and play a pivotal role in driving network performance, cost containment strategy, and growth initiatives across all lines of business. Key Responsibilities Hold full signing authority for provider and vendor/TPA contracts, including negotiation of rates, terms, and performance standards across all network segments Lead the design, build-out, and ongoing optimization of a national provider network serving P&C and workers' compensation payers, employers, and TPAs Develop and execute network strategy aligned with geographic coverage goals, specialty access needs, and competitive positioning Identify, recruit, and credentialize physicians, occupational health providers, hospitals, urgent care centers, and ancillary providers to fill network gaps in key markets Own end-to-end TPA and managed care organization (MCO) relationships — from initial outreach and contract execution through ongoing performance management Establish network performance metrics and drive accountability through data-driven review processes Collaborate with claims, utilization management, and care coordination teams to ensure network design supports clinical and operational outcomes Partner with sales, account management, and product teams to position network assets competitively in new business development and RFP responses Monitor regulatory and compliance requirements across states related to workers' compensation network access and adequacy Build and lead a high-performing network development and contracting team; mentor staff and cultivate internal talent Maintain current knowledge of market trends, competitor networks, and pricing benchmarks to inform strategy Qualifications 10+ years of progressive experience in provider network development, contracting, or network management within the Medicare Advantage industry Comfortable working in a startup style environment (less than 60 employees) Demonstrated experience holding signing authority and leading complex, multi-state contract negotiations with providers and vendor organizations Deep understanding of workers' compensation billing, fee schedules, state regulations, and Managed Care principles Proven track record of building or scaling provider networks at a regional or national level Experience managing TPA relationships and navigating the MCO/TPA vendor landscape Strong financial acumen with the ability to evaluate contract economics, model pricing scenarios, and assess network ROI Exceptional negotiation, communication, and executive presence skills Experience leading and developing teams in a remote, matrixed environment Bachelor's degree required; MBA, MHA, or JD a plus Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual's skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs. With that said, as required by local law in geographies that require salary range disclosure, Vaco/Highspring notes the salary range for the role is noted in this job posting. The individual may also be eligible for discretionary bonuses, and can participate in medical, dental, and vision benefits as well as the company's 401(k) retirement plan.

Additional disclaimer:

Unless otherwise noted in the job description, the position Vaco/Highspring is filing for is occupied. Please note, however, that Vaco/Highspring is regularly asked to provide talent to other organizations. By submitting to this position, you are agreeing to be included in our talent pool for future hiring for similarly qualified positions. Submissions to this position are subject to the use of AI to perform preliminary candidate screenings, focused on ensuring minimum job requirements noted in the position are satisfied. Further assessment of candidates beyond this initial phase within Vaco/Highspring will be otherwise assessed by recruiters and hiring managers. Vaco/Highspring does not have knowledge of the tools used by its clients in making final hiring decisions and cannot opine on their use of AI products.