Manager, Network Development

Posted:
11/26/2025, 2:37:33 AM

Location(s):
Richmond, Kentucky, United States ⋅ Kentucky, United States

Experience Level(s):
Expert or higher ⋅ Senior

Field(s):
Business & Strategy

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Job Summary:
The Manager, Network Development, is responsible for overseeing both managed care operations and business development functions to drive network growth, contract performance, and strategic alignment across payers, providers, and business partners. This role leads teams focused on provider relations, care coordination support, contract compliance, and new business opportunities, while serving as a key liaison between internal stakeholders and external payer and employer networks. The Manager reports directly to the Chief Business Development Officer and ensures that all efforts align with organizational goals, regulatory requirements, and revenue growth strategies.

Reports to: Chief Business Development Officer

Responsibilities:
• Lead the operational performance of managed care functions, including payer relations, contract compliance, and reimbursement strategy, while supporting ongoing regulatory readiness.
• Oversee and support staff responsible for business development, enrollment, and network engagement, ensuring alignment with performance, access, and growth goals.
• Negotiate, evaluate, and implement payer contracts, including redline review, reimbursement terms, and strategic rate adjustments to optimize net revenue.
• Analyze payer and contract performance data to identify trends, resolve escalated issues, and recommend strategies for financial and operational improvement.
• Act as a primary liaison with payers, brokers, employers, and internal stakeholders, ensuring strong relationships and responsiveness to external concerns.
• Support development of new business strategies, outreach initiatives, and market growth plans in coordination with Enrollment Specialists and Business Development staff.
• Prepare executive-level reports and presentations on managed care performance, business development activity, and network trends for senior leadership.
• Monitor healthcare and insurance industry trends to inform strategic planning and advise leadership on potential impact to contracting, development, and access.

Education and Experience
• Bachelor’s in business, Healthcare Administration, Finance, or related field required.
• Master’s degree preferred.
• Minimum of 7 years of experience in managed care, healthcare contracting, or related field.
• Minimum of 3 years of leadership or management experience.

Required Licensures/Certifications/Registrations
• N/A

Skills and Abilities
• Knowledge of managed care principles, payer contracting, and reimbursement methodologies.
• Strong negotiation, analytical, and problem-solving skills.
• Ability to interpret and apply contractual and regulatory requirements.
• Effective leadership, team management, and staff development abilities.
• Strong organizational and time management skills with ability to manage multiple priorities.
• Proficiency in Microsoft Office Suite and healthcare data systems.
• Ability to maintain professionalism and confidentiality in all situations.

Interaction with Other Departments and Other Relationships
The person in this role will have daily interactions with department directors and senior level management for obtaining and reporting information used for decision making.

Physical Capabilities
Position requires prolonged periods of sitting at a desk, talking on a phone, and working on a computer. Essential hearing and near vision acuity are required. Should be able to lift up to 20 pounds, push, pull, and stooping required at times.

Environmental/Working Conditions
Work area is in an office environment, well lit, and subject to varying indoor temperatures.

Direct Reports
Business Development Specialists & Enrollment Specialists

UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

*Request for accommodations in the hire process should be directed to UMC Human Resources.​*