Healthcare Contract Manager
7 days ago
MedPOINT Management is seeking a highly skilled Healthcare Contract Manager to join their team. As a key member of the Provider Network Operations department, you will play a critical role in managing and supporting the administrative and operational aspects of the PNO Contracts Team.
About the Role
The successful candidate will be responsible for provider negotiations, network research, and analysis. You will perform contract negotiations to close IPA network gaps and meet Federal, State, and Health Plan regulatory requirements. Additionally, you will maintain and ensure the quality of provider contracts to meet market standards for language and rates.
Main Responsibilities
• Prepare, negotiate, and implement contracts and Letters of Agreement (LOAs) for physicians and ancillary providers
• Identify and resolve provider network adequacy and specialty needs for network growth
• Ensure contract compliance with DMHC, DHS, CMS, and other regulatory agencies
• Collaborate with the Contracts Supervisor and PNO leadership to meet departmental goals and requirements
• Escalate and summarize problematic issues related to payer contracting to PNO leadership
• Proofread, edit, and fact-check legal documents for accuracy and consistency
• Work with the Contracts Coordinator to analyze new contract requests (LOIs) and develop proposals
• Manage the contract lifecycle, including recruiting, negotiating, and contracting with healthcare providers
• Assess contract rates and identify opportunities to align with market standards and performance
• Ensure completeness and follow up on provider applications, supporting documents, and Health Plan attestations
Requirements
• Bachelor's degree in healthcare or related field preferred
• 4+ years Managed Care or Healthcare experience in Network Management or Contracting
• Knowledge of contracting principles and tools, experience in legal/paralegal process a plus
• EZ-CAP knowledge preferred
• Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)
• Substantive knowledge of the HMO marketplace including Medi-Cal, Commercial, and Medicare
• Strong customer service skills with the ability to resolve complaints and concerns
• Excellent attention to detail with accurate communication and documentation
• Proven ability to analyze information and think critically
• Skilled in multi-tasking, time management, and meeting deadlines
• Effective in working positively in a dynamic, fast-paced team environment
Benefits
MedPOINT Management offers competitive salaries and benefits in a collaborative working environment.
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