Manager, Provider Relations & Contracting

Fidelis Care - New Jersey; New Jersey; Remote; USD 86,000 - 155,000; Full time

Job summary

An established industry player is seeking a Manager for Provider Relations & Contracting to lead recruitment and contracting efforts. This role involves negotiating contracts, developing strategies for network growth, and ensuring compliance with regulations. You will monitor business processes for efficiency, oversee contract execution, and build long-term relationships with providers. With a focus on operational performance, this remote position offers a competitive salary and a range of benefits, including health insurance and flexible work arrangements. If you are passionate about making a difference in healthcare, this opportunity is for you.

Benefits

Health Insurance

401K

Stock Options

Tuition Reimbursement

Paid Time Off

Flexible Work Arrangements

Qualifications

• 5+ years in contracting or provider relations, preferably in healthcare.
• Supervisory experience and familiarity with Medicaid are a plus.

Responsibilities

• Manage provider recruitment, contracting, and retention activities.
• Ensure compliance with policies and regulations in provider contracting.
• Analyze reports to recommend improvements to management.

Skills

Contract Negotiation

Provider Relations

Project Management

Compliance Management

Education

Bachelor’s Degree

Master’s Degree

Job description

Manager, Provider Relations & Contracting

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Position Overview

As a Manager, Provider Relations & Contracting, you will be responsible for developing and managing provider recruitment, contracting, and retention activities. Your role includes negotiating contracts, developing strategies for network growth, and ensuring compliance with policies and regulations.

Key Responsibilities

1. Monitor and improve business processes related to provider contracting for efficiency and compliance.
2. Prepare and oversee provider contracts to ensure timely execution.
3. Manage fee schedules and ensure accurate data entry in our systems.
4. Oversee provider contract compliance and address non-compliance issues.
5. Conduct administrative audits of provider agencies.
6. Analyze reports to recommend improvements to management.
7. Monitor operational and financial performance of provider agreements.
8. Develop long-term relationships with providers and resolve operational issues.
9. Review contract language and provide recommendations on redlines.
10. Travel up to 50% for provider and team meetings.

Qualifications

Bachelor’s degree in a related field or equivalent experience; Master’s preferred. Minimum of 5 years in contracting, network development, or provider relations, preferably in healthcare or insurance, with project management experience. Supervisory experience and familiarity with Medicaid are a plus.

Additional Details

This is a remote position within New Jersey, based in Iselin, NJ. Candidates must reside in New Jersey. Compensation ranges from $86,000 to $154,700 annually. Benefits include health insurance, 401K, stock options, tuition reimbursement, paid time off, and flexible work arrangements.

We are an equal opportunity employer committed to diversity. Qualified applicants will be considered regardless of background or characteristics protected by law.