Provider Engagement

Nomihealth
Worldwide Remote
Remote

Who this role is best for

Aimed at mid-level to senior network builders and contract negotiators who can manage multi-market agreements and thrive in a remote work arrangement.

Best fit for

  • Candidates with experience in payer or TPA environments and managing multi-market provider contracts
    — “Proven experience building and expanding provider networks for a payer, third-party administrator (TPA), provider organization, or network business”
  • Professionals with strong reimbursement knowledge and ability to interpret claims and utilization data
    — “Working knowledge of professional and outpatient reimbursement, including CPT and HCPCS coding, fee schedules, and case rates, plus the ability to interpret claims and utilization data”

Things to consider

  • The role demands a strong ability to manage deadlines and pipelines autonomously in a remote setting
    — “Self-starter who manages their own pipeline and deadlines and works effectively in a remote environment”
  • Candidates must be prepared to coordinate with multiple internal teams through the entire contract lifecycle
    — “Collaborative team player who coordinates with internal teams from negotiation through implementation”

How to stand out

  • Highlight specific examples of negotiating multi-market or multi-site provider agreements in your resume and interviews
    — “Experience negotiating multi-site or multi-market agreements with physician platforms, ASC operators, or ancillary organizations”
  • Emphasize your ability to model costs and explain financial impacts using claims and utilization data
    — “Evaluate fee schedules, Medicare-based rates, case rates, and bundled payments with Pricing and Analytics, and model expected costs using claims, utilization, and site-of-care data”
  • Demonstrate your understanding of provider value propositions, especially direct access to employer-sponsored populations
    — “Articulate Nomi’s provider value proposition, including direct access to employer-sponsored populations”
  • Showcase your experience with ancillary providers such as labs, behavioral health, or therapy services
    — “Local, Regional and National ancillary organizations: such as but not limited too laboratory, behavioral health, therapy, and durable medical equipment providers”
  • Demonstrate your ability to align contract terms with employer launch timelines and service needs
    — “Partner with regional and health system contracting leads to prioritize gaps by specialty, geography, appointment availability, and employer launch timing”
Pace · SteadyCollaboration · HighAutonomy · MediumDecision Impact · Team

Derived from job-description analysis by Serendipath's career intelligence engine.

What success looks like

  • expanding provider networks
  • closing complex contracts
  • managing negotiations across multiple markets
Typical background
experience in payer, TPA, provider organization, or network business

Skills & requirements

Required

Network BuildingContract NegotiationRelationship ManagementCommercial Provider AgreementsReimbursement And Participation TermsClaims And Utilization Data AnalysisCommunication SkillsSelf-starterTeam Player

Preferred

Legal KnowledgeNetwork Operations

Stack & domain

Network BuildingContract NegotiationProvider NetworksReimbursement And Participation TermsClaims And Utilization DataContractingCPT And Hcpcs CodingFee SchedulesCase RatesContract-related Claims IssuesCommunicationTeam PlayerSelf-starterCollaborativeNegotiationProblem-solvingProject ManagementHealthcarePharmacyHospitalityFinanceLegalNetwork Operations

About the role

Original posting from Nomihealth via Lever

Role overview

Nomi Health is looking for a self-directed network builder and contract negotiator to expand our employer-sponsored provider networks. You will build relationships and secure agreements with large physician organizations, ambulatory surgery centers (ASCs), freestanding facilities, and local, regional or national ancillary providers. You will manage a portfolio of strategic accounts and shift your contracting effort to priority markets where a launch, employer opportunity, or service gap requires additional provider access. This role works remotely and partners closely with colleagues across Provider Engagement, Pricing and Analytics, Legal, and Network Operations.

Provider portfolio

Physician organizations: large primary care and multispecialty groups, specialty platforms, physician-hospital organizations (PHOs), and clinically integrated networks (CINs) with contracting authority

Ambulatory and freestanding facilities: ASC operators and independent surgery centers, imaging centers, urgent care centers, and infusion facilities

Local, Regional and National ancillary organizations: such as but not limited too laboratory, behavioral health, therapy, and durable medical equipment providers

Key responsibilities

Build and grow provider networks by developing account plans, cultivating relationships with provider executives and contracting leaders, and owning negotiations from outreach and proposal through internal approval and execution.

Negotiate reimbursement and participation terms across a wide range of provider specialties and facility types, within approved parameters. Evaluate fee schedules, Medicare-based rates, case rates, and bundled payments with Pricing and Analytics, and model expected costs using claims, utilization, and site-of-care data.

Partner with regional and health system contracting leads to prioritize gaps by specialty, geography, appointment availability, and employer launch timing. Pursue local contracts or multi-market agreements based on where each can expand usable access.

Articulate Nomi’s provider value proposition, including direct access to employer-sponsored populations, member steerage through benefit design where applicable, and streamlined claims and payment workflows.

Work with Legal and Network Operations to confirm covered entities, services, and locations, validate provider rosters, and hand off credentialing, directory, rate-loading, and claims-testing requirements before go-live.

Required qualifications

Proven experience building and expanding provider networks for a payer, third-party administrator (TPA), provider organization, or network business

Progressive experience negotiating commercial provider agreements, with a record of closing complex contracts

Broad negotiating experience across a wide range of provider specialties, including direct contracting with large physician groups, ASCs, freestanding facilities, or ancillary providers, and the ability to manage negotiations across multiple markets

Working knowledge of professional and outpatient reimbursement, including CPT and HCPCS coding, fee schedules, and case rates, plus the ability to interpret claims and utilization data and explain the financial impact of contract terms

Strong communication skills with provider executives and the ability to work through competing priorities

Self-starter who manages their own pipeline and deadlines and works effectively in a remote environment

Collaborative team player who coordinates with internal teams from negotiation through implementation

Preferred qualifications

Experience with self-funded employer plans, direct-to-employer networks, tiered benefits, or site-of-care strategies

Experience negotiating multi-site or multi-market agreements with physician platforms, ASC operators, or ancillary organizations

Experience with a broad number of provider specialties, professional, ancillary and other.

How success is measured

Priority network gaps closed by specialty, geography, and service line, with contracted sites available by agreed launch dates

Target agreements executed and activated, with progress tracked against pipeline milestones and contracting timelines

Contracted rates and projected allowed costs compared with approved benchmarks, with post-launch utilization and allowed costs reviewed alongside Analytics

Implementation quality measured by roster accuracy, rate validation, and timely resolution of contract-related claims issues

Completion of market specific network adequacy standards

Source: Nomihealth careers (Lever)

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