Vendor Contract and Performance Specialist III

L.A. Care Health Plan•Los Angeles, CA

2d•$88,854 - $142,166•Onsite

About The Position

The Vendor Contract and Performance Specialist III serves as a strategic partner within the provider ecosystem, leading complex contracting efforts and ensuring alignment with organizational strategies and regulatory standards to optimize vendor value. This position bridges cross-functional teams to mitigate risk and control costs. Acting as the primary liaison for provider relations, the Specialist drives proactive engagement, oversees onboarding and education, and maintains transparent communication across the network. Oversee external healthcare partners, contracted medical groups and third-party service vendors. Ensures vendors adhere to regulatory policies, data security guidelines and internal compliance standards. This role manages the full lifecycle of provider issues, applying analytical frameworks to resolve concerns and developing scalable solutions that enhance provider and member experience. The Specialist operationalizes value-based care initiatives, monitors contractual benchmarks, and synthesizes data into actionable insights for leadership. Cross-functional collaboration is central, uniting internal teams to achieve provider performance goals. Reinforces structured processes, and models data-driven decision making, fostering a culture of accountability and service excellence. Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff.

Requirements

Bachelor's Degree in Related Field
At least 4 years of progressive experience in managed care contracting, provider relations, health plan operations, vendor operations, or hospital/facility settings.
Demonstrated success negotiating, executing, and ensuring regulatory compliance for complex agreements.
At least 3 years in provider-facing progressively responsible professional roles with executive-level relationship management.
Proven track record coordinating cross-functional initiatives and using data to improve outcomes.
Advanced expertise in negotiating and managing high-value, complex agreements.
Deep knowledge of managed care operations and delegated risk environments.
Strong expertise in root-cause analysis, operational improvement, and data-driven decision-making, ensuring strong SLA governance.
Effective stakeholder management skills which bridge cross functional groups, while high level presence enables provider advocacy, conflict resolution, and strategic team development.
Excellent organizational skills, adept at managing multiple projects, documenting decisions, and following through on action items.
Proficiency with office productivity tools supports robust analysis, clear presentations, and timely stakeholder updates.
Travel to offsite locations for work required.

Nice To Haves

In lieu of degree, equivalent education and/or experience may be considered.
Extensive experience with Medi-Cal, Medicare Advantage, DHCS, DMHC, CMS, and NCQA.
Adept in capitation, value-based care, provider contracting, and hospital partnerships.
Advanced knowledge of provider data management, directory standards, and regulatory reporting supports effective oversight.
Ability to lead provider training, crafts targeted communications, and resolve complex operational and payment issues.
Familiarity with medical coding frameworks (ICD-10, CPT) and cross-functional collaboration skills which enables strong representation of contracting and provider relations in organizational initiatives.

Responsibilities

Serves as a strategic integrator across the entire provider ecosystem, contracting, relationship management, engagement, and performance oversight.
Leads high‑value contracting efforts, negotiates and executes complex agreements across professional, facility, vendor, and ancillary providers while ensuring that contractual terms align with organizational strategy and regulatory expectations.
Negotiates service level agreements.
Tracks vendor key performance indicators, scorecards and operational efficiency.
Functions as the primary liaison between the organization and its diverse provider network, driving structured, proactive engagement that strengthens relationships and promotes operational excellence.
Oversees orientation, onboarding, education, and continuous communication, ensuring transparency and consistency across all provider interactions.
Responsible for the full lifecycle of provider concerns, applying a disciplined approach from intake to root‑cause analysis through solution development and validation.
Leverages analytical frameworks to assess financial, regulatory, member, and operational impacts.
Applies this expertise enables the timely resolution of escalated issues, the prevention of recurring challenges, and the development of scalable solutions that enhance both provider and member experience.
Responsible for operationalizing value‑based care initiatives and monitoring progress against contractual benchmarks, synthesizing data into actionable insights for leadership review.
Through structured project practices, drives implementations to successful, on‑schedule completion and prepares analytic reports that inform enterprise decision‑making.
Acts as a central coordinator who unites internal teams to align efforts, share insights, and ensure collective execution against provider performance goals.
Reinforces structured processes and documentation standards, and modeling disciplined, data‑driven decision‑making.
Provides guidance to help shape a culture of accountability, responsiveness, and service excellence within the provider engagement and contracting functions.
Apply subject matter expertise in evaluating business operations and processes.
Identify areas where technical solutions would improve business performance.
Consult across business operations, provide mentorship, and contribute specialized knowledge.
Ensure that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices.
Provide training and recommend process improvements as needed.
Performs other duties as assigned.