Regional Contracts Manager

SCAN Health Insurance•Long Beach, CA

12d•$92,400 - $133,671•Remote

About The Position

The Regional Contracts Manager will partner with the Senior Regional Director and the regional team to develop and manage business partnerships with SCAN's contracted providers, including delegated medical groups, IPAs, health systems, and hospitals. This role is crucial for achieving SCAN’s financial performance, enhancing member experience, improving quality outcomes, and supporting long-term growth. Working collaboratively with Provider Relations and cross-functional leaders, this position plays a key role in advancing SCAN's mission to keep seniors healthy and independent.

Requirements

Bachelor's Degree or equivalent experience.
5 years of managed care contracting experience with complex provider organizations.
2-3 years of leadership experience.
Knowledge of CMS, DHCS, and other regulatory requirements related to delegated risk.
Strong analytic, quantitative, and problem-solving skills.
Strong negotiation, interpersonal, and presentation skills with the ability to appropriately and effectively address diverse audiences.
Advanced technical skills for the functional area.
Advanced Microsoft Office Suite (Word, Excel, PowerPoint, Access, Outlook, Teams), and SQL are required.
Excellent written and verbal communication and interpersonal skills.

Nice To Haves

Curiosity about AI and its power to transform operations and member service.

Responsibilities

Serve as a support negotiator for high-impact agreements with delegated medical groups, IPAs, hospitals, and integrated delivery systems.
Collaborate with internal business units to model expected yield, monitor actual contract performance, and assess the feasibility of non-template terms and conditions, following appropriate approval processes.
Act as a technical resource for contract-related issues, providing strong leadership both internally and externally.
Review, analyze, and redline contract documents in accordance with organizational standards, risk tolerance, and contractual objectives, applying sound professional judgment to negotiate and resolve terms.
Be accountable for the performance of assigned provider network in relation to financial, operational, regulatory, quality, and member satisfaction targets.
Establish and maintain productive business relationships with SCAN’s contracted network providers, including medical groups, IPAs, hospitals, and integrated delivery systems.
Partner with actuarial, finance, and operational teams to evaluate the financial and operational implications of contract strategies.
Utilize contracting knowledge for effective problem resolution and compliance.
Ensure timely and professional interaction in response to contract-related inquiries.
Research, analyze, and resolve complex problems related to hospital shared risk pools, claims, appeals, and eligibility issues within appropriate limits.
Navigate non-standard and complex deal structures, balancing financial performance, compliance, and long-term partnership value.
Ensure that the day-to-day operations of the provider network are consistent with SCAN standards and expectations.
Actively support the achievement of SCAN’s Vision and Goals.
Perform other duties as assigned.

Benefits

Base salary range: $92,400 to $133,671 per year
Annual employee bonus program
Robust Wellness Program
Generous paid-time-off (PTO)
Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
Excellent 401(k) Retirement Saving Plan with employer match and contribution
Robust employee recognition program
Tuition reimbursement
Opportunity to become part of a team that makes a difference to our members and our community every day
Competitive compensation and benefits program
A work-life balance