Provider Network Contract Manager III

Health insurance that's with you, every step of the way. • Minnetonka, MN

1d • $78,700 - $118,020 • Hybrid

About The Position

Medica is a nonprofit health plan serving more than a million members in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. The Provider Network Contract Manager III develops, negotiates, and maintains a competitive, geographically comprehensive provider network that supports affordability, trend management, and business objectives. The role ensures contracts align with organizational reimbursement standards, regulatory requirements, and internal controls, while supporting predictable network performance for customers and partners. It builds collaborative relationships with hospitals, physicians, pharmacies, and ancillary providers to maintain an appropriate mix of specialties and network stability. This high-level individual contributor works independently, manages complex contracting initiatives, and serves as a resource to internal teams. Other duties may be assigned.

The position is an office role requiring onsite work, on average, three days per week, at one of Medica’s offices in Minnetonka, Minnesota; Madison, Wisconsin; Omaha, Nebraska; or St. Louis, Missouri. The full salary grade is $78,700–$134,900, with a typical hiring range of $78,700–$118,020. Salary placement depends on factors including education, experience, certifications or licensure, role scope, internal pay equity, and market data. The position may also be eligible for incentive compensation. Medica does not offer work visa sponsorship; candidates must be legally authorized to work in the United States at the time of application, and employment is contingent on verification of identity and work eligibility.

Requirements

• Bachelor’s degree or equivalent experience in a related field.
• At least 5 years of work experience in a healthcare environment.

Nice To Haves

• Payer/provider contract negotiation experience.
• Revenue cycle knowledge and/or experience.
• Experience building relationships and establishing trust at all levels.
• Health plan operations and/or provider operations experience.
• Excellent written, verbal, and presentation communication skills.
• Proven ability to cultivate and maintain effective, collaborative external relationships in which parties trust the information conveyed.
• A successful track record negotiating contracts for healthcare services, providers, or health plans.
• Knowledge of provider contracting components and strategies, including risk-based contracting, financial models, operational impact, and data analytics.
• Strong financial, analytical, and problem-solving skills, and understanding of legal documents.

Responsibilities

• Evaluate market dynamics and provider availability to support a competitive, geographically adequate network.
• Monitor unit cost performance and trend metrics in alignment with affordability goals.
• Coordinate with internal stakeholders to ensure network decisions support product and regulatory requirements.
• Assess contract terms, reimbursement structures, and negotiation strategies against company standards and financial targets.
• Lead negotiations with hospitals, physicians, and ancillary providers to reach sustainable, mutually beneficial agreements.
• Ensure contracts comply with templates, legal requirements, and internal process controls.
• Conduct financial analyses of the cost and utilization impacts of proposed and final contract terms.
• Build provider relationships and serve as a key contact for concerns, expectations, and issue resolution.
• Communicate performance data, contract requirements, and network initiatives to providers.
• Support provider understanding of reimbursement models and operational workflows.
• Represent the organization in provider meetings, partnership discussions, and network-related forums.
• Analyze claims, cost, and utilization patterns to identify opportunities to improve contracting or network performance.
• Use market intelligence and benchmarking to support negotiation strategies and decisions.
• Use and edit models to prepare summaries and recommendations for leadership based on financial and operational data.
• Monitor competitor actions and regulatory changes that may affect the network.
• Recommend improvements to contracting processes, documentation, and workflow efficiency.
• Partner with legal, finance, provider operations, and medical management teams to support smooth contract implementation.
• Support cross-team initiatives such as value-based contracting, quality programs, and cost-of-care strategies.
• Share expertise and guidance with colleagues to strengthen team capabilities and contracting effectiveness.
• Perform other duties as assigned.

Benefits

• Competitive medical, dental, and vision coverage.
• Paid time off (PTO).
• Paid holidays.
• Paid volunteer time off.
• 401(k) contributions.
• Caregiver services.
• Other benefits as part of a total rewards package.
• Potential eligibility for incentive plan compensation in addition to base salary.

What This Job Offers

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