Strategic ACO Contract Manager

Medica•Omaha, NE

1d•Remote

About The Position

Medica is a nonprofit health plan serving more than a 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, stable, and aligned with unit-cost performance and trend-management objectives. The role supports affordable, predictable networks for customers and business partners by evaluating and negotiating contracts in accordance with company templates, reimbursement standards, and process controls. It also establishes and maintains strong business relationships with providers and ensures appropriate distribution of provider specialties across the network. The role manages provider contracts throughout their lifecycle, including negotiation, drafting, renewals, amendments, maintenance, monitoring, and closure. It builds relationships with providers and key contracting entities, resolves provider issues and disputes, assesses provider and network performance, and supports network adequacy, provider recruitment, and provider marketing. This is a remote position. 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. The full salary grade is $100,300–$172,000; the typical hiring range is $100,300–$150,465. Placement depends on factors including education, experience, certifications or licensure, scope and responsibility, internal pay equity, and market data. The position may also be eligible for incentive compensation. Medica does not offer work visa sponsorship, and candidates must be legally authorized to work in the United States.

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 built on trust.
Proven success 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 and analyze them to determine viable options.
Primary home address in one of the listed states where Medica is registered as an employer.
Legally authorized to work in the United States at the time of application; work visa sponsorship is not offered.

Responsibilities

Develop and maintain competitive, geographically appropriate, stable provider networks that meet unit-cost performance and trend-management objectives.
Evaluate and negotiate provider contracts in compliance with company templates, reimbursement standards, and process controls.
Establish and maintain strong relationships with hospital, physician, pharmacy, and ancillary providers, including high-level representatives of key contracting entities.
Ensure network composition includes an appropriate distribution of provider specialties.
Negotiate and draft contract terms aligned with Medica's financial goals and standard template agreements.
Track critical contract dates and manage renewals and amendments.
Maintain contractual language and fee schedules to reflect current medical policy changes and reimbursement structures.
Oversee contracts from initiation and negotiation through execution, monitoring, and closure.
Address provider issues and lead dispute-resolution processes.
Assess assigned networks and providers to identify performance and improvement opportunities.
Participate in network adequacy, provider recruitment, and provider marketing activities.
Perform other duties as assigned.