Network Contracting Specialist

Rancho Health MSO, Inc • San Buenaventura (Ventura), CA

10d

About The Position

The intent of this job description is to provide a summary of the major duties and responsibilities performed in this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description. The Network Contracting Specialist is responsible for developing, negotiating, and maintaining provider network agreements to ensure adequate access, competitive cost structures, and compliance with regulatory standards. This role serves as a liaison between the organization and healthcare providers, supporting strategic initiatives for network growth and cost containment.

Requirements

• Bachelor’s degree in Business, Healthcare Administration, or related field (or equivalent experience).
• 3+ years in provider contracting, network management, or managed care operations,
• Experience negotiating complex contracts and understanding reimbursement methodologies.
• Strong negotiation and relationship-building skills; financial acumen and ability to analyze cost impacts.
• Proficiencyin Microsoft Office; experience with contract management systems (e.g., Cobblestone,EzCap).
• Knowledge of Medicare Advantage and Commercial health plan operations.
• Existing relationships with providers in the assigned geographic area.
• Ability to work independently and manage multiple priorities in a fast-paced environment.

Responsibilities

• Contract Negotiation & Management: Negotiate contracts with physicians, physician groups, and ancillary providers; prepare, execute, and track provider agreements, amendments, and fee schedules; analyzefinancial impactof contract terms and alternative reimbursement models; ensuretimelyrenewals and manage contract expirations.
• Network Development: Recruit providers to meet network adequacy and access requirements;maintainstrong relationships with providers and internal stakeholders; support credentialing coordination and onboarding processes.
• Compliance & Data Integrity: Ensure contractscomply withstate and federal regulations (e.g., Medicare, Medi-Cal);maintainaccurateprovider data in internal systems;assistwith audits and regulatory reporting related to network adequacy.
• Operational Support: Prepare reports and presentations on contracting activities; collaborate with Claims, Medical Management, and Compliance teams; resolve escalated provider service issues and inquiries.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level