Provider Contract Negotiator (San Diego Region)
About The Position
The Provider Contract Negotiator negotiates, administers, and maintains contracts and relationships with primary care physicians, specialists, ancillary providers, and hospitals to support a high-quality, cost-effective, compliant provider network in the San Diego Region. The role supports managed care growth initiatives and organizational goals by identifying and onboarding providers, ensuring regulatory compliance, and building strong relationships with existing partners. It also assists with tracking progress, enhancing brand visibility, and efforts to secure new contracts. Success requires strong communication skills, attention to detail, and a solid understanding of the healthcare industry.
Requirements
- Bachelor's degree in a related field and 2 years of relevant experience in provider contracting, contract interpretation, negotiation, or client relations; alternatively, 3 years of relevant experience in lieu of a degree.
Nice To Haves
- Healthcare experience in a managed care setting or with a physician group, clinical-based organization, or hospital/facility setting.
- Experience with Medicaid, Medicare Advantage, or commercial provider networks.
- Experience with contract lifecycle management systems and provider databases.
- Experience with provider reimbursement methodologies such as fee-for-service, capitation, and value-based models.
- Experience with healthcare regulatory requirements related to provider networks, such as CMS, DHCS, DMHC, and NCQA.
Responsibilities
- Negotiate, administer, and maintain provider contracts and relationships.
- Support a high-quality, cost-effective, and compliant provider network in the San Diego Region.
- Identify and onboard new providers.
- Ensure regulatory compliance.
- Foster strong partnerships with existing providers and partners.
- Assist in tracking progress, enhancing brand visibility, and securing new contracts.
Benefits
- Medical, dental, and vision insurance
- 403(b) retirement savings plans with employer matching contributions
- Flexible Spending Accounts
- Commuter Flexible Spending
- Career advancement and development opportunities
- Paid Time Off and holidays
- Paid CME Days
- Malpractice insurance and tail coverage
- Tuition reimbursement program
- Corporate employee discounts
- Employee referral bonus program
- Pet care insurance
- May qualify for discretionary bonuses or incentives
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
