Curana Health is a provider of value-based primary care services for the senior living industry, including skilled nursing facilities, assisted & independent living communities, Memory Care units, and affordable senior housing sites. Our 1,000+ clinicians serve more than 1,500 senior living community partners across 34 states, and Curana participates in various innovative CMS programs (including owned-and-operated Accountable Care Organizations and Medicare Advantage plans). With rapid year-over-year growth since our founding in 2021, Curana is setting a new standard in innovative care delivery for seniors with high-risk, complex clinical needs, many of whom have been historically underserved by the healthcare system. Our mission: To radically improve the health, happiness and dignity of senior living residents.

The Network Strategy Manager is responsible for overseeing the evaluation, monitoring, and remediation of provider network adequacy to ensure compliance with federal, state, and contractual requirements. This role ensures the organization maintains sufficient access to healthcare services for its members by identifying network gaps, driving remediation strategies, and supporting regulatory filings such as CMS, Medicaid, accreditation and state-based submissions.

• Lead the Network Data Analysts in the development and implementation of network adequacy strategies to meet regulatory and accreditation standards.
• Manage the network analyst vendor relationship, coordinating updates, changes and enhancements to the system.
• Manage provider network data life cycle.
• Monitor network performance against adequacy benchmarks and proactively identify areas of non-compliance.
• Collaborate with provider contracting, development and credentialing teams to address network gaps and develop corrective action plans.
• Serve as subject matter expert during regulatory audits, triennial CMS submissions, expansion filings and readiness reviews.
• Maintain the provider network policies and procedures according to regulatory, state and accreditation guidelines.
• Analyze provider data and reporting tools to assess sufficiency and access across lines of business.
• Lead network filings, narratives, and documentation for regulatory submissions and internal reporting.
• Develop and maintain tracking tools and dashboards to monitor adequacy status in real-time.
• Partner with cross-functional teams including Credentialing, IT, Provider Services, and Compliance to ensure alignment and accuracy of provider data.
• Maintains plan Health Service Delivery Tables (HSD).
• Coordinate remediation efforts, including developing timelines and tracking progress through resolution.
• Stay informed of changing regulatory standards and translate them into operational action plans. Works with the data analysts to aggregate and analyze provider data from various sources to recommend and implement solutions to assist with network development activities.
• Advocates for rational and appropriate processes relating to the provider experience that will limit administrative burdens for both the plan and the provider network.
• Serves as key resource for contracting staff and provides mentoring and on-the-job training and development. Other duties as assigned.

Education

Bachelor’s degree in Healthcare Administration, Public Health, Business, or related field. Master’s degree preferred.

KNOWLEDGE, SKILLS AND ABILITIES  

• Strongly prefer experience in data analytics related to health care
• 5+ years of experience in healthcare network management, provider relations, or compliance.

• 5+ years’ experience with data analysis and data management, claims payment and configuration

• Adept in navigating regulatory, state and accreditation requirements for provider network.
• Advanced proficiency in MS Excel and MS Access experience  
• In depth experience with CMS network filings (HSD’s Tables and Provider Exceptions).
• Ability and desire to function in a fast-paced, highly matrixed environment.  
• Strong organizational skills and ability to effectively work independently while also being a team player. 

Curana Health is dedicated to the principles of Equal Employment Opportunity. We affirm, in policy and practice, our commitment to diversity. We do not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable or state law, genetic information, or any other characteristic protected by applicable federal, state and local laws and ordinances.

The EEO policy applies to all personnel matters as outlined in our company policy including recruitment, hiring, transfers, and general treatment during employment.

*The company is unable to provide sponsorship for a visa at this time (H1B or otherwise).