Health Plan Provider Contracts Manager

Job Summary

A company is looking for a Health Plan Provider Contracts Manager - Complex.

Key Responsibilities

• Negotiate contracts and agreements with complex provider groups to ensure high-quality and cost-effective care
• Manage and optimize value-based contracts while supporting network adequacy and financial performance
• Evaluate provider networks and implement strategic plans to meet network adequacy standards

Required Qualifications

• At least 5 years of experience in network contracting with large provider groups and 3 years in provider contract negotiations
• Familiarity with managed health care provider compensation methodologies, particularly in Medicaid and Medicare
• Strong negotiation and relationship-building capabilities
• Ability to navigate complex regulatory environments
• Proficiency in Microsoft Office suite and applicable software programs