Contracts Manager
About The Position
The Manager of Contracting is responsible for the day-to-day management, negotiation, implementation, and administration of payer, provider, and vendor contracts for LSMA Management, Inc., LaSalle Health Plan, and Maren Medical Group. Under the direction of the Vice President of Contracting, the Manager oversees contracting activities that support organizational objectives, provider network development, reimbursement optimization, and regulatory compliance. The Manager develops and maintains productive relationships with health plans, physicians, hospitals, ancillary providers, and strategic vendors while coordinating contract negotiations, implementation, amendments, renewals, and ongoing contract performance. This position collaborates closely with Finance, Medical Management, Provider Relations, Credentialing, Compliance, Legal Counsel, and Operations to ensure contractual obligations are effectively implemented and monitored. The Manager is responsible for maintaining contract documentation, monitoring reimbursement performance, supporting value-based care initiatives, ensuring compliance with applicable federal and California healthcare regulations, and supervising the daily operations of the Contracting department.
Requirements
- Bachelor's degree in Healthcare Administration, Business Administration, Finance, Public Health, or related field required.
- At least five to seven years of progressively responsible healthcare contracting experience.
- Minimum three (3) years of supervisory or project leadership experience.
- Experience negotiating managed care payer and provider contracts.
- Experience within an MSO, IPA, health plan, medical group, ACO, or integrated delivery system.
- Experience with Commercial, Medicare Advantage, and Medi-Cal reimbursement models.
- Thorough knowledge of healthcare contracting principles.
- Knowledge of managed care reimbursement methodologies.
- Understanding of provider network development.
- Knowledge of CMS, DHCS, DMHC, and California managed care regulations.
- Strong contract negotiation skills.
- Financial analysis and reimbursement modeling abilities.
- Excellent written and verbal communication skills.
- Ability to interpret legal agreements.
- Strong organizational and project management skills.
- Ability to supervise multiple projects simultaneously.
- Proficiency in Microsoft Office and contract management software.
- Strong interpersonal and relationship-building skills.
Nice To Haves
- Master's degree (MBA, MHA, MPH, JD, or related discipline).
- California managed care contracting experience.
- Experience with delegated services agreements.
- Experience supporting value-based payment programs.
Responsibilities
- Day-to-day management, negotiation, implementation, and administration of payer, provider, and vendor contracts.
- Overseeing contracting activities that support organizational objectives, provider network development, reimbursement optimization, and regulatory compliance.
- Developing and maintaining productive relationships with health plans, physicians, hospitals, ancillary providers, and strategic vendors.
- Coordinating contract negotiations, implementation, amendments, renewals, and ongoing contract performance.
- Collaborating with Finance, Medical Management, Provider Relations, Credentialing, Compliance, Legal Counsel, and Operations to ensure contractual obligations are effectively implemented and monitored.
- Maintaining contract documentation.
- Monitoring reimbursement performance.
- Supporting value-based care initiatives.
- Ensuring compliance with applicable federal and California healthcare regulations.
- Supervising the daily operations of the Contracting department.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
