Contracting Systems Manager – Health Plan

Jobtailor; Long Beach (CA); On-site; USD 120,000 - 160,000; Full time

Job summary

Jobtailor is seeking a Contract Management Specialist in California to serve as the contracting SME for QNXT and other enterprise systems. You will oversee contract-to-configuration alignment, review complex reimbursement methods, and lead testing activities to ensure accurate system outcomes.

You will partner with IT, Claims, and operations to resolve issues, establish controls, and support renewals and amendments. Strong analytics and MS Office skills are required.

Qualifications

• Bachelor's degree or equivalent experience in Healthcare Administration, Business Administration, Finance, Information Systems, Public Health, or related field

Responsibilities

• Serve as the Contracting subject matter expert for QNXT, contract management system, and other enterprise system implementations.
• Provide oversight and validation of contract-to-configuration alignment to ensure provider agreements are accurately operationalized.
• Review complex reimbursement methodologies and contract provisions to identify risks associated with system configuration and claims adjudication.
• Lead contract-related testing activities including UAT, parallel testing, payment validation, and go-live readiness assessments.
• Identify, investigate, and elevate discrepancies between contract intent and system outcomes.
• Partner with Configuration, Claims, IT, Provider Operations, and implementation teams to develop solutions for contract implementation issues.
• Establish and maintain processes and controls that support ongoing contract-to-system accuracy.
• Serve as the primary business resource for contract implementation, renewals, amendments, and system enhancement initiatives.
• Analyze operational and financial impacts of contract implementation decisions and provide recommendations to leadership.
• Lead special projects and process improvement initiatives supporting enterprise contracting and payment accuracy objectives.

Skills

Contract Management

Qnxt

Healthcare Systems

Risk Analysis

Testing Leadership

Cross-Functional Collaboration

Data Analysis

Advanced MS Office

Education

Bachelor's degree or equivalent in Healthcare/Business/Finance/IS/Public Health

Tools

QNXT

Contract Management Systems

Enterprise Systems

Job description

• Serve as the Contracting subject matter expert for QNXT, contract management system, and other enterprise system implementations.
• Provide oversight and validation of contract-to-configuration alignment to ensure provider agreements are accurately operationalized.
• Review complex reimbursement methodologies and contract provisions to identify risks associated with system configuration and claims adjudication.
• Lead contract-related testing activities including UAT, parallel testing, payment validation, and go-live readiness assessments.
• Identify, investigate, and elevate discrepancies between contract intent and system outcomes.
• Partner with Configuration, Claims, IT, Provider Operations, and implementation teams to develop solutions for contract implementation issues.
• Establish and maintain processes and controls that support ongoing contract-to-system accuracy.
• Serve as the primary business resource for contract implementation, renewals, amendments, and system enhancement initiatives.
• Analyze operational and financial impacts of contract implementation decisions and provide recommendations to leadership.
• Lead special projects and process improvement initiatives supporting enterprise contracting and payment accuracy objectives.

Requirements

• Bachelor's degree or equivalent experience in Healthcare Administration, Business Administration, Finance, Information Systems, Public Health, or related field
• 5+ years of experience in managed care, provider contracting, network management, claims operations, configuration support, healthcare systems implementation, or related healthcare or health insurance plan operations.
• Experience interpreting and applying complex provider contract terms, reimbursement methodologies, and payment arrangements.
• Experience participating in large-scale operational or technology implementations.
• Experience collaborating across multiple business functions, including Contracting, Claims, Configuration, Operations, Network Management, Finance, and Information Technology.
• Experience supporting testing, validation, issue resolution, implementation readiness, and production support activities for business-critical systems.
• Strong analytical experience identifying operational, financial, payment, and implementation risks and developing recommendations for resolution.
• Microsoft Office (Word, Excel, PowerPoint, Teams, Outlook) at advanced skill level.

Core Competencies

Demonstrates expertise in Contract Management and Healthcare Systems Implementation, with a strong focus on contract-to-configuration alignment, risk analysis, and process improvement. Proficient in leading testing activities and collaborating across multiple business functions to ensure operational accuracy and compliance.

Highest-signal resume keywords

• Contract Management Expertise
• Healthcare Systems Implementation
• Risk Analysis and Mitigation
• Testing and Validation Leadership
• Cross-Functional Collaboration

ATS Optimization Keywords

Hard Skills

• Contract Interpretation
• Reimbursement Methodologies
• Claims Operations
• Configuration Support
• Operational Analysis
• Financial Impact Analysis
• Issue Resolution
• Implementation Readiness
• Process Improvement
• Advanced Microsoft Office

Soft Skills

• Analytical Thinking
• Problem Solving
• Communication
• Collaboration
• Leadership

Industry Keywords

• Managed Care
• Provider Contracting
• Network Management
• Health Insurance Operations
• Healthcare Administration

Tools & Technologies

• QNXT
• Contract Management Systems
• Enterprise Systems