Provider Contracting Manager

HMSA•Honolulu, HI

1d•Hybrid

About The Position

The Provider Contracting Manager is responsible for actively participating in shaping, informing, leading, and implementing HMSA's overall corporate strategy for its providers. This role plays an integral part in supporting and implementing various strategic provider initiatives, collaborating closely with other HMSA Departments including Office of Payment Transformation, Finance and Accounting, Medical Management, Medicare and Medicaid Programs, IHMS, and Market and Product Strategy to coordinate and implement these initiatives. Key responsibilities include developing, shaping, and evaluating financial proposals for provider negotiations, such as value-based payments and alternative payment models, and negotiating standard and nonstandard agreements with providers. The role also involves managing the disbursement of funds for contract obligations, monitoring program effectiveness, developing strong partnerships with providers and internal HMSA departments, and maintaining contractual records and documentation. Additionally, the Provider Contracting Manager will develop and implement contract management procedures, prepare reports on contract status, and contribute to corporate initiatives and training on contracting practices.

Requirements

Bachelor's degree and five years of contract preparation/administration, financial management and/or related work experience; or equivalent combination of education and related work experience.
Experience with a highly regulated industry.
Experience negotiating contracts and/or vendor/contract management.
Communicate clearly and concisely, both verbally and in writing.
Establish and maintain effective working relationships with those contacted in the course of work.
Excellent interpersonal skills.
Strong analytical skills.
Strong planning and organization skills.
Excellent leadership skills.
Good working knowledge of Microsoft Office applications.

Responsibilities

Develop, shape, and evaluate financial proposals for provider negotiations, including value-based payment and alternative payment models.
Negotiate standard and nonstandard agreements with providers, reviewing redlined contracts and making language recommendations.
Monitor and manage the disbursement of funds for HMSA contract obligations for non-claims expenses.
Develop close partnerships with providers to lead and drive HMSA's mission, vision, values, and provider strategy.
Develop close partnerships with various HMSA Departments to continuously develop and improve HMSA's provider strategy.
Coordinate provider contractual requirements to ensure appropriate implementation and administration of provider contracts.
Maintain contractual records and documentation, ensuring signed contracts are communicated to all relevant parties.
Develop and implement procedures for contract management and administration in compliance with company policy and to mitigate risk.
Prepare regular reports on the status of contracts and negotiations based on detailed analysis.
Work directly on corporate initiatives, provide guidance on contract matters, and conduct training on contracting practices and procedures.