Provider Contracting Manager jobs in California

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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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 campus â€" a rejuvenating place for associates systemwide to collaborate, innovate and connect.

    Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

    Job Summary:

    Directs provider contracting activities on behalf of the organization. Develops, maintains and revises policies and procedures for the operations and compliance of provider contracting. Works with executive management on issues or escalated items. Assists in the management of medical group contracting as well as system-wide provider compensation practices. Oversees the development and implementation of a contracting system including cataloging, standardizing, measuring performance and ensuring compliance. Supervises and directs the activities of various levels of assigned personnel utilizing both professional and supervisory discretion and independent judgment.

    Job Requirements:

    Education and Work Experience:

    • Bachelor's Degree or equivalent combination of education/related experience: Required
    • Master's Degree: Preferred
    • Five years' related experience: Preferred
    • One year leadership experience: Preferred

    Essential Functions:

    • Oversees the contract development for providers across the system. Takes appropriate actions to facilitate the timely flow of contract documents through the approval process. Manages the database of the provider contract terms and ensures communication to all stakeholders.
    • Works with legal and compliance teams on escalated provider issues. Communicates issues to legal and compliance and assists in resolution as necessary. Provides advanced knowledge and understanding of legal and regulatory requirements related to provider contracting and compensation. Maintains responsibility to ensure contract compliance standards are applied and maintained.
    • Develops close relationships with hospital leadership, communicating as needed, to ensure the collaborative management of provider contracts.
    • Participates in various subject-focus meeting groups to provide insight, expertise, metrics and data on provider contracting.
    • Exercises independent judgment in recruiting, training, coaching, supervising and directing assigned associates.
    • Performs other job-related duties as assigned.

    Organizational Requirements:

    Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.

  • 22 Days Ago

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Provider Contracting Specialist, Principal
  • Hispanic Technology Executive Council
  • Long Beach, CA FULL_TIME
  • Your Role The Provider Network Management team consists of Provider Relations and Contracting in Northern California. The Provider Contracting Specialist, Principal will report to the Director, Provid...
  • 18 Days Ago

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Provider Contracting Specialist, Principal
  • BSC
  • Long Beach, CA FULL_TIME
  • Your Role The Provider Network Management team consists of Provider Relations and Contracting in Northern California. The Provider Contracting Specialist, Principal will report to the Director, Provid...
  • 19 Days Ago

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Provider Contracting Specialist, Senior
  • Blue Shield of CA
  • Long Beach, CA FULL_TIME
  • Your Role The Network Management team handles provider contracting and provider relations statewide. The Provider Contracting Specialist, Senior will report to the Director, Provider Contracting. In t...
  • 24 Days Ago

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Contracting Manager
  • The Travel Corporation (TTC)
  • Cypress, CA FULL_TIME
  • Description: ABOUT US We are driven by service through PASSION, PEOPLE & PURPOSE. A Family of Brands making travel matter for over 100 years. The Travel Corporation is made up of a team of individuals...
  • 20 Days Ago

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Credentialing and Contracting Medical Provider Network Specialist
  • TRISTAR MANAGED CARE INC
  • Fresno, CA FULL_TIME
  • This will be a remote position. JOB SUMMARY: The Credentialing and Contracting Specialist is responsible for preparing and maintaining contracts and the contracts database system. Maintain active stat...
  • 27 Days Ago

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Associate Manager - Contract Management
  • Novo Nordisk
  • Plainsboro, NJ
  • About the Department The Clinical, Medical and Regulatory (CMR) department at Novo Nordisk is one of the most diverse an...
  • 6/11/2024 12:00:00 AM

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Contracts Manager
  • Inari Medical, Inc.
  • Irvine, CA
  • Description The Contracts Manager, working independently, closely collaborates with the finance, legal, compliance, and ...
  • 6/11/2024 12:00:00 AM

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Manager - Contract Management and Payer Variance
  • ChristianaCare
  • Wilmington, DE
  • Are you looking for a career opportunity with growth potential at a healthcare organization that is based on excellence ...
  • 6/11/2024 12:00:00 AM

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Provider Contract Management Specialist
  • Naphcare, Inc.
  • Birmingham, AL
  • Overview: NaphCare has an excellent opportunity for a Provider Contracting Specialist to join our Regional Office in Pho...
  • 6/10/2024 12:00:00 AM

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Manager Contract Management
  • McDermott
  • Houston, TX
  • Job Description Company Overview: People power our future. That is why advancing a dynamic, inclusive environment, where...
  • 6/10/2024 12:00:00 AM

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Associate Provider Contract Manager
  • Kaiser Permanente
  • Burbank, CA
  • Description: Job Summary:Manages and conducts specific functions of the contracting and provider relations process. This...
  • 6/7/2024 12:00:00 AM

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Senior Provider Contract Manager
  • Kaiser Permanente
  • Oakland, CA
  • Description: Job Summary:Manages and conducts specific functions of the contracting and provider relations process. This...
  • 6/7/2024 12:00:00 AM

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Senior Manager-Contract Management, Americas
  • Idaho State Job Bank
  • Boise, ID
  • Senior Manager-Contract Management, Americas at Marriott in Boise, Idaho, United States Job Description Job Number 24034...
  • 6/7/2024 12:00:00 AM

California is a state in the Pacific Region of the United States. With 39.6 million residents, California is the most populous U.S. state and the third-largest by area. The state capital is Sacramento. The Greater Los Angeles Area and the San Francisco Bay Area are the nation's second and fifth most populous urban regions, with 18.7 million and 9.7 million residents respectively. Los Angeles is California's most populous city, and the country's second most populous, after New York City. California also has the nation's most populous county, Los Angeles County, and its largest county by area, S...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Manager jobs
$120,975 to $160,657

Provider Contracting Manager in Gastonia, NC
By simplifying and automating the provider contracting lifecycle, we help make it easier for health plans to identify and implement savings opportunities to obtain maximum value from provider relationships.
January 09, 2020
Provider Contracting Manager in Springfield, IL
Responsible for the oversight of their assigned networks to ensure network provider deficiencies are being met and working closely with their assigned Network Support staff and Medical Management counterparts to ensure network needs/changes are being effectively addressed and communicated both internally and externally.
January 19, 2020
Provider Contracting Manager in Cedar Rapids, IA
New care delivery models, complex regulations and narrowing provider networks have significantly altered the provider contract management process.
February 03, 2020