Provider Contract Negotiator

Job Summary

Responsible for negotiating, developing, implementing, and managing provider contracts, the full-time remote Provider Contract Negotiator will focus on Medicaid, Medicare Advantage, and Commercial lines of business while ensuring regulatory compliance and supporting value-based payment initiatives.

Key responsibilities

• Lead complex negotiations and perform financial and reimbursement analysis for provider contracts
• Develop contracting strategies aligned with organizational objectives and ensure compliance with regulatory requirements
• Collaborate cross-functionally to support total cost of care management and value-based payment initiatives

Required qualifications

• Bachelor's degree in Business Administration, Healthcare Administration, Finance, or a related field, or equivalent experience
• Three years of progressive experience in provider contracting, network management, or managed care operations
• Experience negotiating hospital and/or professional agreements
• Familiarity with Medicaid, Medicare Advantage, and Commercial lines of business preferred
• Knowledge of value-based payment models and risk-based contracting