California Network Contract Manager

Job Summary

Evaluating and negotiating provider contracts, the full-time Senior Network Contract Manager will manage unit cost budgets and collaborate with stakeholders to develop competitive provider networks while working remotely from anywhere within the U.S.

Key responsibilities

• Evaluate and negotiate provider contracts in compliance with company templates and reimbursement methodologies
• Draft, execute, and manage Single Case Agreements in coordination with clinical teams and provider partners
• Manage unit cost budgets, target setting, and performance reporting, utilizing financial models for decision-making

Required qualifications

• 5+ years of experience in a network management-related role with accountability for business results
• 5+ years of experience in the health care industry
• 2+ years of experience with provider contracting, including product pricing development and financial modeling
• Prior experience in the California market
• In-depth knowledge of Capitation, PMPM, Fee For Service, and Medicare Resource Based Relative Value System (RBRVS)