Provider Contract Specialist (Remote with ~20% Local Travel) – San Antonio, TX

Alignment Healthcare•San Antonio, TX

15d•$59,877 - $89,816•Hybrid

About The Position

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Alignment Health is seeking a Provider Contract Specialist to support the growth and performance of our provider network in the San Antonio market. In this role, you’ll identify, recruit, and contract with providers—owning the process from initial outreach through signed agreement. This is not a coordination role. You will be directly negotiating contract terms, handling redlined language, and working through provider pushback while representing Alignment Health’s interests in a professional and solutions-oriented way. Strong Excel skills (e.g., pivot tables, VLOOKUPs) will be important for managing contract data and tracking performance. The role is primarily remote, with approximately 20% local travel (with mileage reimbursement) to provider offices in the San Antonio / New Braunfels area (no air travel required). When not meeting with providers, you’ll work from home drafting contracts, managing documentation, and collaborating with internal teams including claims, clinical, and network management. This role is well-suited for someone who is detail-oriented, persistent, and comfortable having direct conversations to move agreements forward.

Requirements

Minimum 5 years’ experience in provider relations / contracting with an HMO or IPA, medical group or institutional provider required
Demonstrated experience negotiating contract terms and redlined language (beyond facilitating or coordinating contracts) required.
High School Diploma or GED.
Bachelor's degree or four years additional experience in lieu of education.
Strong analytic, quantitative, and problem-solving skills required.
Strong verbal and written communication skills required.
Strong presentation skills and ability to appropriately and effectively address diverse audiences required.
Proficiency in MS Word and Excel required;
Maintain reliable means of transportation.
If driving, must have a valid driver’s license and automobile insurance.
Drives approximately 20% of the time to provider sites.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Nice To Haves

Advanced Excel skills, including pivot tables and VLOOKUPs, strongly preferred.
Access database proficiency preferred.

Responsibilities

Provider Contracting & Network Development
Recruit new providers in assigned specialty(ies) and regions to support CMS network adequacy and expansion goals.
Negotiate contract terms and redlined language directly with providers within established parameters, demonstrating sound judgment and the ability to navigate objections without reliance on leadership for routine negotiations.
Draft and implement contracts in accordance with department guidelines with physicians and/or ancillary providers to support existing and developing markets.
Review Letters of Interest and distribute to the Contract Manager per department guidelines.
Secure patient specific Letters of Agreement for non-contracted providers when requested by UM or Market Leadership.
Credentialing, Documentation & Data Management
Prepare and maintain contract documentation and supporting materials to ensure accuracy, completeness, and audit readiness.
Request and obtain necessary credentialing information/documents for new providers and monitor credentialing status to ensure timely contract execution and network participation.
Populate and maintain the contract tracker by promptly and accurately entering key contractual information, verifying data for accuracy and completeness, and ensuring records are consistently up to date.
Compliance, Communication & Provider Relations
Serve as resource for internal customers for provider contracting questions, ensuring timely professional and effective communication.
Ensure overall compliance by responding to grievances/appeals and adhering to regulatory and departmental Policy and Procedure guidelines and timeframes.
Process and communicate provider network changes, including additions, terminations, demographic updates, panel closures, and contractual risk changes in a timely manner to ensure accurate provider directories, Alignment systems, and internal stakeholder awareness.
Cross-Functional Collaboration & Departmental Support
Participate in interdepartmental meetings and committees to support Network Management initiatives and organizational objectives.
Contribute to departmental goals by supporting team initiatives and performing other related duties as assigned.
Other duties and projects not listed above.