Provider Contracting Manager jobs in the United States

Provider Contracting Manager manages the activities of the contracting staff that prepare and maintain contracts and the contracts database system for a health plan network. Responsible for negotiating with facilities joining the health network and setting rates. Being a Provider Contracting Manager oversees network reporting requirements to ensure compliance with regulatory agencies, and to produce accurate and relevant reporting of data. Trains and develops staff. Additionally, Provider Contracting Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Provider Contracting Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Provider Contracting Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

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Director of Provider Development & Contracting
  • Provider Partners Health Plan
  • Indianapolis, IN FULL_TIME
  •  
    Provider Partners is searching for a results-oriented individual, with a proven track record, who is passionate about our mission and can generate positive outcomes based on that mission. The Director of Provider Development & Contracting plays a pivotal role in managing and developing relationships with healthcare providers within our network. This position is responsible for ensuring a high level of provider satisfaction and service while optimizing network performance and strategy.
     
    Key Responsibilities: 
     
    Provider Relationship Management:
    • Serve as the primary contact for healthcare providers.
    • Maintain and enhance strong, long-term relationships with providers.
    • Address and resolve provider inquiries and concerns in a timely and professional manner.
    • Conduct provider orientations and provide ongoing education on PPHP policies, procedures, and new initiatives.
    Network Development and Management:
    • Identify, recruit, and contract with new providers to expand our network.
    • Negotiate contract terms, rates, and agreements with providers.
    • Analyze network performance, identify gaps, and recommend improvements.
    • Work collaboratively with internal teams to ensure network adequacy and to develop network strategies.
    Performance Monitoring and Reporting:
    • Monitor provider performance metrics and ensure compliance with contractual and regulatory requirements.
    • Prepare and present network performance reports to senior management.
    • Evaluate provider satisfaction and recommend strategies for improvement.
    Compliance and Regulatory Adherence:
    • Ensure provider compliance with state, federal, and PPHP regulations and standards.
    • Stay abreast of changing regulatory requirements and ensure timely communication to providers and internal stakeholders.
    Project Management:
    • Lead and participate in cross-functional projects aimed at improving network performance and provider satisfaction.

    Qualifications:
    • Bachelor’s degree in healthcare administration, business, or related field required; Master’s degree preferred.
    • Minimum of 5-10 years of experience in healthcare network management or provider relations in the state of Indiana.
    • Strong knowledge of healthcare industry, contract negotiations, and regulatory compliance.
    • Excellent communication and interpersonal skills with the ability to build strong relationships with providers and internal teams.
    • Strong analytical and problem-solving skills.
    • Ability to manage multiple priorities in a fast-paced environment.
    • Proficient in Microsoft Office Suite (Word, Excel, PowerPoint).

  • 1 Month Ago

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Manager, Provider Contracting
  • Adventist Health
  • Roseville, CA FULL_TIME
  • Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified ca...
  • Just Posted

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Senior Provider Contracting Manager
  • FourStone Partners
  • West Chester, PA FULL_TIME
  • FourStone Partners is an innovative consulting firm specializing in business development, sales outsourcing, and operational support services within the Workers' Compensation industry. FourStone Partn...
  • 20 Days Ago

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Manager, Provider Contracting - NE market
  • The Cigna Group
  • Portland, ME FULL_TIME
  • LOCATION: Based in Newton, MA office The Manager, Provider Network Contracting serves as an integral member of the Provider Contracting Team and reports to the Provider Contracting Senior Manager. Thi...
  • 15 Days Ago

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Manager, Provider Contracting - NE market
  • The Cigna Group
  • Newton, MA OTHER,FULL_TIME
  • The job profile for this position is Provider Contracting Advisor, which is a Band 4 Senior Contributor Career Track Role.Excited to grow your career?We value our talented employees, and whenever poss...
  • 15 Days Ago

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Manager, Health Plans Provider Contracting
  • University of Utah Health
  • Murray, UT OTHER
  • OverviewAs a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission require...
  • 1 Month Ago

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Commercial Contracts Manager - REMOTE
  • Comrise
  • Columbus, OH
  • Job Title: Commercial Contracts Manager (Remote) Job Overview: **5-Month Contract Position (W-2) with High Potential for...
  • 5/19/2024 12:00:00 AM

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Sr. Project Manager
  • AllyRecuit
  • Columbus, OH
  • Job Description Job Description • Set up the schedule of values. • Own and manage all project aspects to ensure on-time ...
  • 5/17/2024 12:00:00 AM

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Sr. Project Managers
  • AllyRecuit
  • Columbus, OH
  • Job Description Job Description • Set up the schedule of values. • Own and manage all project aspects to ensure on-time ...
  • 5/16/2024 12:00:00 AM

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Grants amp; Contracts Management Analyst
  • Ohio State University Wexner Medical Center
  • Columbus, OH
  • Job Description Grants amp; Contracts Management Analyst will oversee and manage all post-award activities for assigned ...
  • 5/16/2024 12:00:00 AM

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Sr. Project Managers
  • AllyRecuit
  • Commercial Point, OH
  • Job Description Job Description • Set up the schedule of values. • Own and manage all project aspects to ensure on-time ...
  • 5/16/2024 12:00:00 AM

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Sr. Project Managers
  • AllyRecuit
  • Lewis Center, OH
  • Job Description Job Description • Set up the schedule of values. • Own and manage all project aspects to ensure on-time ...
  • 5/16/2024 12:00:00 AM

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Sr. Project Managers
  • AllyRecuit
  • Plain City, OH
  • Job Description Job Description • Set up the schedule of values. • Own and manage all project aspects to ensure on-time ...
  • 5/16/2024 12:00:00 AM

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Associate Director, Lab Services
  • The Ohio State University Wexner Medical Center
  • Columbus, OH
  • The Ohio State University Wexner Medical Center is ranked in the top 3 percent of U.S. hospitals and is ranked the No. 2...
  • 5/15/2024 12:00:00 AM

Income Estimation for Provider Contracting Manager jobs
$109,431 to $145,324

Career Path for Provider Contracting Manager