Manager, Network

Role Scope: 

The Network Manager is responsible for the strategic development, execution, and ongoing management of Habitat Health’s provider network across assigned markets and service lines. This role translates organizational network strategy into operational execution while ensuring that the provider network supports comprehensive service delivery, regulatory compliance, and high quality participant care within the PACE model. 

The Network Manager oversees provider contracting, provider recruitment, onboarding, and ongoing provider relationship management while ensuring that contracted providers are successfully integrated into Habitat Health’s operational and clinical workflows. This role serves as a senior liaison between Habitat Health leadership, center operations, and external provider organizations and is responsible for ensuring that contractual terms, regulatory expectations, billing requirements, credentialing standards, and care coordination processes are consistently implemented across the network. 
 
In addition to direct provider engagement, the Network Manager is responsible for overseeing network adequacy planning, supporting market expansion initiatives, guiding complex contract negotiations, and managing internal network development processes. The role may also provide supervision and guidance to network specialists or analysts responsible for supporting contracting and provider operations. Drafting, negotiating, and managing provider contracts, amendments, single case agreements, and letters of agreement for traditional and non-traditional providers required to support a comprehensive PACE network. 

• Lead the development and execution of network strategy within assigned markets to ensure a comprehensive, compliant, and accessible provider network that supports the full scope of PACE services. 

• Identify network gaps, service capacity needs, and strategic provider partnerships based on participant utilization patterns, geographic access requirements, regulatory standards, and program growth projections. 

• Lead complex provider contracting negotiations and oversee the development of provider agreements, amendments, letters of agreement, and single case agreements for both traditional and non traditional providers. 

• Establish and maintain strategic provider relationships with key health systems, specialty providers, community based organizations, and ancillary service partners required to support comprehensive PACE care delivery. 

• Oversee provider recruitment efforts across critical service areas including specialty physician services, behavioral health, home based care, transportation, durable medical equipment, dialysis, infusion, dental, and other essential services. 

• Direct provider onboarding and integration activities to ensure providers understand the PACE model, authorization workflows, billing requirements, claims submission processes, and interdisciplinary care coordination expectations. 

• Serve as a senior escalation point for provider operational issues including claims disputes, contract interpretation, service delivery concerns, credentialing requirements, and participant care coordination challenges. 

• Monitor provider network performance and compliance with contractual obligations and regulatory standards and implement corrective actions or performance improvement strategies when needed. 

• Maintain oversight of provider and contract tracking tools to ensure accurate documentation, reporting, and regulatory readiness. 

• Support cross functional collaboration with clinical operations, finance, credentialing, compliance, and center leadership to ensure alignment between network development, operational workflows, and participant care delivery. 

• Support new market launches and expansion initiatives through proactive provider recruitment, contracting strategy development, and establishment of foundational network partnerships. 

• Provide guidance, mentorship, and operational oversight to network specialists or other team members supporting contracting and provider relations activities. 

• Identify opportunities to improve network development processes, contracting efficiency, provider onboarding, and operational integration across markets. 

Qualifications 

• Bachelor’s degree in healthcare administration, business administration, public health, or a related field required. 

• Master’s degree in healthcare administration, public health, business administration, or related discipline preferred. 

• Minimum 6 to 8 years of experience in provider contracting, network development, managed care, or health plan operations. 

• Demonstrated experience leading healthcare provider contract negotiations and managing provider networks within a managed care, integrated delivery, or value based care environment. 

• Strong understanding of Medicare and Medicaid reimbursement methodologies, provider billing practices, and managed care contracting structures. 

• Experience developing and managing provider networks that support multi service care delivery models. 

• Working knowledge of regulatory and compliance requirements related to provider participation within Medicare or Medicaid programs. 

• Proven ability to manage multiple provider relationships, contracts, and operational priorities across complex healthcare markets. 

• Strong written and verbal communication skills with the ability to translate contractual and regulatory requirements into operational guidance. 

• Demonstrated ability to build and maintain strategic relationships with health system leaders, community providers, and internal stakeholders. 

• Strong analytical and organizational skills with proficiency in Microsoft Excel, Word, and provider network management tools. 

• Ability to operate effectively in a rapidly growing organization and lead initiatives within evolving operational environments. 

Nice to have: 

• Prior experience working in a PACE program or with PACE providers. 

• Experience with nontraditional provider types such as home and community based services, transportation, DME, dental, behavioral health, dialysis, or infusion services. 

• Familiarity with delegated credentialing models and credentialing documentation requirements. 

• Experience supporting claims issue resolution or billing education for providers. 

• Exposure to network adequacy reporting or provider directory management. 

Compensation:  

We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for medical/dental/vision insurance, short and long-term disability, life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays. The expected salary range for this position is $106,000 - $121,000. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. 

Vaccination Policy, including COVID-19 

At Habitat Health, we aim to provide safe and high-quality care to our participants. To achieve this, please note that we have vaccination policies to keep both our team memb