Provider Contract Manager
About The Position
Our Provider Contract Manager oversees the full lifecycle of provider and vendor agreements to support the delivery of high-quality healthcare services to plan members. They are responsible for negotiating competitive contract terms, drafting and maintaining agreements, and ensuring compliance with organizational and regulatory standards. This Provider Contract Manager requires building and sustaining strong, collaborative relationships with independent providers, health systems, third-party networks, and vendor partners. Key responsibilities include negotiating reimbursement rates, managing contract renewals, resolving disputes, and optimizing contract performance to align with business objectives and network strategy.
Requirements
- Bachelor’s degree in a related field, or equivalent combination of education and relevant work experience.
- 5 or more years of experience in contracting, provider relations, or network development
- Proven experience in contract negotiations.
- Strong critical thinking and analytical skills.
- Excellent communication skills with the ability to influence and build relationships across various stakeholders.
Nice To Haves
- Experience in contracting for healthcare services within a health plan network or for a health care provider organization.
- Experience working with a variety of healthcare reimbursement models for professional, facility and ancillary services.
- Familiarity with the Wisconsin provider landscape.
- Strong experience using MS Excel and other Microsoft Office applications.
Responsibilities
- Serve as the primary relationship manager for assigned providers, ensuring strong communication, engagement, and satisfaction.
- Negotiate and execute provider contracts, including rates, reimbursement methodologies, and contract terms, in compliance with regulatory requirements.
- Analyze contract performance and provider data to ensure alignment with organizational goals related to cost, quality, utilization, and member satisfaction.
- Educate providers on policies, tools, and resources to enhance collaboration and improve overall provider experience.
- Collaborate cross-functionally to resolve provider issues, support network operations, and drive process improvements.
- Support strategic initiatives and contracting innovations while ensuring accurate system configuration and network validation for agreements.
Benefits
- Remote and hybrid work options available
- Performance bonus and/or merit increase opportunities
- 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
- Competitive paid time off
- Health insurance, dental insurance, and telehealth services start DAY 1
- Professional and Leadership Development Programs
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
