VP, Provider Network (Medicare Advantage)

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, delivers integrated services across the Medicare Advantage Insurance Markets. Compensation: $200,000-250,000 + discretionary bonus & benefits Reports to: President/CEO Position Overview Hiring a strategic VP, Provider Network to lead the development, expansion, and management of the company's provider and vendor network across the Medicare Advantage Plan space in Mississippi and Oklahoma. This executive-level role carries full contracting authority and serves as the primary relationship owner for the company's 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
• 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. Equal Opportunity Notice Highspring LLC (d/b/a Vaco by Highspring) and its parents, affiliates, and subsidiaries ("we," "our," or "Vaco by Highspring") are committed to the full inclusion of all qualified individuals and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by applicable law. The company is also committed to ensuring that persons who need them are provided with reasonable accommodations; if an accommodation is needed to participate in the job application or interview process, please contact [email protected] . Vaco by Highspring also wants all applicants to know their rights that workplace discrimination is illegal. Representation Notice By submitting to this position, you agree that you will be giving Vaco by Highspring the exclusive right to present your as a candidate for the foregoing employment opportunity. Additionally, you agree to be included in our talent pool for future hiring for similarly qualified positions. You further agree that you have represented information about yourself accurately and have not affirmatively misrepresented your qualifications. Lastly, you agree to maintain as confidential, to the fullest extent permitted by law, any information you learn from Vaco by Highspring about the position and you will limit disclosure of information about the position only to the extent necessary to perform any obligations in furtherance of your application. In exchange, Vaco by Highspring agrees to exercise reasonable efforts to represent you through all solicitation, job screening and resume dispersal. For residents of Ontario, Canada only: to the extent the position for employment is not with Highspring or not otherwise noted as vacant above, candidate should be informed that this role is to replace a presently employed person at Vaco by Highspring's client. Privacy Notice Vaco by Highspring respects your privacy and are committed to providing transparent notice of our policies.

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Additionally, 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. More details about Vaco by Highspring's use of AI can be found here (https://www.highspring.com/ai-use-notices/). Further assessment of candidates beyond this initial phase will be conducted by recruiters and hiring managers. Vaco by Highspring does not know and cannot opine on if its client's use of AI products in hiring. Pay Transparency Notice Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: · the individual's skill sets, experience and training; · licensure and certification requirements; · office location and other geographic considerations; and · other business and organizational needs. With that said, as required by local law, Vaco by Highspring believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure. The individual may also be eligible for discretionary bonuses and/or participation in medical, dental, and vision benefits as well as the company's retirement plan (or similar retirement benefits). Apply tot his job Apply To this Job