Provider Engagement

Responsibilities

• Build and grow provider networks with physician organizations, ASCs, freestanding facilities, and ancillary providers
• Own negotiations from outreach and proposal through internal approval and execution
• Negotiate reimbursement and participation terms within approved parameters
• Evaluate fee schedules, Medicare-based rates, case rates, and bundled payments with Pricing and Analytics
• Prioritize network gaps by specialty, geography, and employer launch timing
• Coordinate with Legal and Network Operations on rosters, credentialing, and go-live requirements

Requirements

• Proven experience building and expanding provider networks for a payer, TPA, provider organization, or network business
• Progressive experience negotiating commercial provider agreements
• Broad negotiating experience across provider specialties and facility types
• Working knowledge of CPT and HCPCS coding, fee schedules, and case rates
• Ability to interpret claims and utilization data and explain financial impact of contract terms
• Strong communication skills with provider executives
• Self-starter who manages their own pipeline in a remote environment

Preferred Qualifications

• Experience with self-funded employer plans, direct-to-employer networks, or site-of-care strategies
• Experience negotiating multi-site or multi-market agreements

About the Company

Nomi Health is a healthcare technology company focused on employer-sponsored provider networks.