Manage complex fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems.
Lead key market contracting strategy projects with responsibility for managing direct reports as assigned.
Build and maintain strong provider relationships to support network growth and value-based business opportunities.
Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure aligned execution.
Develop strategic network positions, identify value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics.
Work to meet unit cost targets while maintaining an adequate, competitive provider network.
Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics.
Prepare, review, and project the financial impact of large or complex provider contracts and alternative terms.
Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration.
Lead resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance.

3+ years of healthcare provider contracting and negotiating experience
Background in managed care, healthcare, or health insurance, including commercial contracting
Proven leadership experience, including mentoring and guiding others
Strong provider relationship management skills and success developing long-term partnerships
Knowledge of complex reimbursement methodologies, including incentive-based models (strongly preferred)
Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences
Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization
Customer-centric approach, strong interpersonal skills, and confidence in navigating change
Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills
Proficiency in Microsoft Office
Bachelor’s degree in a related field (industry experience may substitute); MBA / MHA preferred

Provider Network Contracting Manager

Key skills