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).

  • 21 Days Ago

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Manager, Provider Contracting
  • Altais Health Solutions
  • Oakland, CA FULL_TIME
  • About Our CompanyAt Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, pa...
  • 19 Days Ago

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Manager, Provider Contracting Operations
  • Health Partner Plans, Inc.
  • Pittsburgh, PA FULL_TIME
  • Why Choose Jefferson Health Plans? We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that includ...
  • 9 Days Ago

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Provider Contracting Manager
  • Santa Clara Family Health Plan
  • San Jose, CA FULL_TIME
  • Provider Contracting Manager Salary Range: $104,280 - $161,634The expected pay range is based on many factors, such as experience, education, and the market. The range is subject to change. FLSA Statu...
  • 9 Days Ago

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Manager, Provider Contracting Operations
  • Health Partner Plans, Inc.
  • Harrisburg, PA FULL_TIME
  • Why Choose Jefferson Health Plans? We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that includ...
  • 10 Days Ago

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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...
  • 29 Days Ago

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Area Contracting Manager
  • Trane Technologies plc
  • Columbus, OH
  • At Trane TechnologiesTM and through our businesses including Trane and Thermo King, we create innovative climate solutio...
  • 4/26/2024 12:00:00 AM

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Bilingual Customer Advocate
  • American Electric Power Company, Inc.
  • Columbus, OH
  • 19-Nov-2021 **Bilingual Customer Advocate** 32107BR Columbus, OH Customer Service and Call Center Job Description **Posi...
  • 4/26/2024 12:00:00 AM

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Assistant Project Manager - Mission Critical (Columbus)
  • Burns & McDonnell
  • Columbus, OH
  • Description Burns & McDonnell is a company comprised of more than 14,000 engineers, architects, construction professiona...
  • 4/26/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • Columbus, OH
  • Position: Provider Contract Manager REMOTE Seattle Area Location: Remote - Everett, Seattle, Tacoma, Washington State Me...
  • 4/25/2024 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 ...
  • 4/25/2024 12:00:00 AM

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IT Contracts Manager
  • Select Medical Corp
  • Columbus, OH
  • Select Medical Corp IT Contracts Manager Mechanicsburg , Pennsylvania Apply Now IT Contracts Manager Employer will NOT s...
  • 4/24/2024 12:00:00 AM

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Senior Contracts Manager
  • Nasco
  • Columbus, OH
  • NASCO Senior Contracts Manager Columbus , Ohio Apply Now Under general direction, the Senior Contracts Manager role is r...
  • 4/24/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • Columbus, OH
  • Position: Provider Contract Manager *REMOTE Seattle Area* Location: Remote - Everett, Seattle, Tacoma, Washington State ...
  • 4/22/2024 12:00:00 AM

Income Estimation for Provider Contracting Manager jobs
$109,176 to $144,986

Career Path for Provider Contracting Manager