About The Position

The Provider Contracting Negotiator Manager is a key member of the Provider Contracting team and reports to the AVP of Provider Contracting. This role leads complex provider negotiations and supports the strategic direction and daily management of contracting and network activities for a local market. The work directly supports access to high‑quality, affordable healthcare for patients and families.

Requirements

  • Bachelor’s degree or equivalent relevant industry experience
  • 3+ years of experience in a healthcare environment
  • 3+ years of provider contracting and negotiation experience with complex delivery systems
  • Strong contract, financial, and reimbursement model knowledge, including performance‑based arrangements
  • Advanced Excel skills; able to analyze and manipulate data across multiple formats
  • Proven negotiation, problem‑solving, and decision‑making skills
  • Confident communicator with experience influencing stakeholders and presenting to groups
  • Strong relationship‑building skills with external providers
  • Collaborative, adaptable professional who performs well in fast‑paced, matrixed environments
  • If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Responsibilities

  • Lead complex negotiations for fee‑for‑service and value‑based reimbursement arrangements with hospitals, ancillary providers, and large physician groups
  • Build and manage strong provider relationships; serve as the primary interface between providers and internal business partners
  • Identify and advance value‑based and risk‑based contracting opportunities aligned with local market strategy
  • Partner closely with internal teams, including Claims, Medical Management, Credentialing, Legal, Compliance, Finance, Sales, Marketing, and Service
  • Support network development, alternative network strategies, and related analytics
  • Manage unit cost targets while maintaining an adequate and competitive provider network
  • Develop and lead initiatives that improve total medical cost and quality outcomes
  • Provide consultative support to providers using clinical and financial insights to drive cost and quality improvements
  • Prepare and evaluate financial models, projections, and impact analyses for complex contracts
  • Draft and manage healthcare provider (HCP) agreements that meet operational, legal, and provider requirements
  • Ensure accurate contract implementation, loading, and ongoing maintenance
  • Resolve escalated provider issues through research, negotiation, and cross‑functional collaboration
  • Maintain strong knowledge of the local provider landscape, relationships, and competitive dynamics
  • Provide guidance and support to less experienced contracting staff as needed

Benefits

  • Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
  • We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
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