Role Description

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.

• Oversees provider contracting, provider recruitment, onboarding, and ongoing provider relationship management.
• Ensures that contracted providers are successfully integrated into Habitat Health’s operational and clinical workflows.
• Serves as a senior liaison between Habitat Health leadership, center operations, and external provider organizations.
• Responsible for ensuring that contractual terms, regulatory expectations, billing requirements, credentialing standards, and care coordination processes are consistently implemented across the network.
• Oversees network adequacy planning, supports market expansion initiatives, guides complex contract negotiations, and manages internal network development processes.
• May provide supervision and guidance to network specialists or analysts responsible for supporting contracting and provider operations.
• Drafts, negotiates, and manages provider contracts, amendments, single case agreements, and letters of agreement for traditional and non-traditional providers required to support a comprehensive PACE network.
• Leads 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.
• Identifies network gaps, service capacity needs, and strategic provider partnerships based on participant utilization patterns, geographic access requirements, regulatory standards, and program growth projections.
• Establishes and maintains strategic provider relationships with key health systems, specialty providers, community-based organizations, and ancillary service partners required to support comprehensive PACE care delivery.
• Oversees 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.
• Directs provider onboarding and integration activities to ensure providers understand the PACE model, authorization workflows, billing requirements, claims submission processes, and interdisciplinary care coordination expectations.
• Serves as a senior escalation point for provider operational issues including claims disputes, contract interpretation, service delivery concerns, credentialing requirements, and participant care coordination challenges.
• Monitors provider network performance and compliance with contractual obligations and regulatory standards and implements corrective actions or performance improvement strategies when needed.
• Maintains oversight of provider and contract tracking tools to ensure accurate documentation, reporting, and regulatory readiness.
• Supports cross-functional collaboration with clinical operations, finance, credentialing, compliance, and center leadership to ensure alignment between network development, operational workflows, and participant care delivery.
• Supports new market launches and expansion initiatives through proactive provider recruitment, contracting strategy development, and establishment of foundational network partnerships.
• Provides guidance, mentorship, and operational oversight to network specialists or other team members supporting contracting and provider relations activities.
• Identifies 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.

Requirements

• Prior experience working in a PACE program or with PACE providers (nice to have).
• Experience with nontraditional provider types such as home and community-based services, transportation, DME, dental, behavioral health, dialysis, or infusion services (nice to have).
• Familiarity with delegated credentialing models and credentialing documentation requirements (nice to have).
• Experience supporting claims issue resolution or billing education for providers (nice to have).
• Exposure to network adequacy reporting or provider directory management (nice to have).

Benefits

• Medical/dental/vision insurance.
• Short and long-term disability.
• Life insurance.
• Flexible spending accounts.
• 401(k) savings.
• Paid time off.
• Company-paid holidays.
• Expected salary range: $106,000 - $121,000.