Strategic ACO Contract Manager

Medica•Omaha, NE

2d•$100,300 - $150,465•Remote

About The Position

Medica is a nonprofit health plan serving more than one million members in Minnesota, Nebraska, Wisconsin, Missouri, and other communities. The Strategic ACO Contract Manager develops and maintains provider networks that are competitive, geographically appropriate, and stable, while achieving unit-cost and trend-management objectives. The role supports affordable, predictable networks for customers and business partners and evaluates and negotiates contracts in accordance with company templates, reimbursement standards, and process controls. It also establishes and maintains relationships with hospital, physician, pharmacy, and ancillary providers, ensuring appropriate distribution of provider specialties. Other duties may be assigned. The manager oversees the provider contract lifecycle, including negotiation and drafting, renewals, amendments, maintenance of contract language and fee schedules, execution, monitoring, and closure. The role builds relationships with providers and key contracting entities, addresses provider issues and disputes, assesses network and provider performance, and supports network adequacy, provider recruitment, and provider marketing. This is a remote role. Candidates must have a primary home address in a state where Medica is registered as an employer: AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, or WI. Medica does not offer work visa sponsorship; candidates must be legally authorized to work in the United States at the time of application. The full salary grade is $100,300–$172,000, with a typical hiring range of $100,300–$150,465. 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 describes its total rewards package as including medical, dental, and vision coverage, PTO, holidays, paid volunteer time off, 401(k) contributions, caregiver services, and other benefits.

Requirements

Bachelor’s degree or equivalent experience in a related field.
Eight years of related work experience beyond the degree.
Experience negotiating contracts using various methodologies, including value-based and ACO arrangements.
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 where parties trust the information conveyed.
Successful track record negotiating contracts for health care services, providers, or health plans.
Flexibility and creativity in developing effective contracting terms.
Knowledge of provider contracting components and strategies, including risk-based contracting, financial models, operational impact, and data analytics.
Demonstrated understanding of complex financial arrangements and quality programs across health care products.
Strong financial, analytical, and problem-solving skills, and understanding of legal documents.
Strategic-thinking skills, including the ability to conceptualize a wide range of scenarios, analyze them, and identify viable options.
Legally authorized to work in the United States at the time of application.
Primary home address must be in a state where Medica is registered as an employer: AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, or WI.

Responsibilities

Develop and maintain competitive, geographically appropriate, and stable provider networks that support unit-cost performance and trend-management objectives.
Evaluate and negotiate contracts in accordance with company contract templates, reimbursement standards, and process controls.
Negotiate and draft provider contracts aligned with Medica’s financial goals and standard agreements.
Track critical contract dates and manage renewals and amendments.
Maintain contract language and fee schedules to reflect medical policy changes and reimbursement structures.
Manage the full contract lifecycle from initiation and negotiation through execution, monitoring, and closure.
Build and maintain relationships with providers, including high-level representatives of key contracting entities.
Manage provider relations, address issues, and lead dispute-resolution processes.
Assess assigned networks and providers to identify performance-improvement opportunities.
Support network adequacy, provider recruitment, and provider marketing activities.
Ensure network composition includes an appropriate distribution of provider specialties.
Perform other duties as assigned.