Provider Contracts Manager

Texas Children's Health Plan; Houston (TX); On-site; USD 90,000 - 130,000; Full time

Job summary

Texas Children’s Health Plan in Houston is seeking a Provider Contracts Manager to oversee contracts with providers and negotiate terms that align with regulatory requirements. The role involves drafting, reviewing, and monitoring contracts, and collaborating with internal teams to resolve issues and strengthen provider relationships.

You will analyze utilization and financial data, support network development initiatives, and maintain accurate records to ensure sustainable, high‑quality care

Qualifications

• Experience in provider contracting, payor contracting, or network management within a health plan or managed care environment.
• Negotiation, financial analysis, and contract review skills to interpret reimbursement terms and fee schedules.
• Knowledge of Medicaid, CHIP, and managed care regulations; familiarity with healthcare delivery systems.
• Data analysis and reporting tools (e.g., Excel, databases) to inform contract decisions.
• Excellent written and verbal communication with strong organizational abilities.
• Ability to collaborate with cross-functional teams and build provider/internal relationships.
• Bachelor’s degree in Business/Health Admin/Finance; advanced degree or certification a plus.
• Experience in a Texas managed care setting and familiarity with Texas Medicaid/ CHIP programs.

Responsibilities

• Oversee provider contracts and negotiations; draft and review agreements.
• Monitor contract performance, utilization, and financial data for improvements.
• Collaborate with legal, finance, provider relations, and network management teams.
• Respond to provider inquiries and support network development initiatives.
• Maintain accurate contract records and documentation.

Skills

Negotiation

Financial analysis

Data analysis

Communication

Contract review

Regulatory knowledge

Cross-functional collaboration

Education

Bachelor’s degree in Business Administration

Related field degree

Tools

Excel

Database systems

Job description

Company Description Texas Children’s Health Plan, founded in 1996, is the nation’s first health maintenance organization (HMO) created specifically for children. The organization provides STAR/Medicaid and Children’s Health Insurance Program (CHIP) coverage to pregnant people, teens, children, and adults in Houston and surrounding areas. More than 375,000 members receive care through a broad network of over 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children’s Health Plan is the largest combined STAR/CHIP Managed Care Organization in the Harris County service area, offering comprehensive, community-focused care. Team members join a mission-driven organization dedicated to improving access to quality health care for families across the region.

Role Description The Provider Contracts Manager is a full-time, on-site role based in Houston, TX, responsible for managing and overseeing contracts with providers across the health plan’s network. This role includes negotiating contract terms and reimbursement rates, drafting and reviewing agreements, and ensuring alignment with regulatory requirements and organizational policies. The Provider Contracts Manager monitors contract performance, analyzes utilization and financial data, and collaborates with internal teams to resolve contract-related issues and improve provider relationships. Daily responsibilities also involve responding to provider inquiries, supporting network development initiatives, and maintaining accurate contract records and documentation. The role works closely with legal, finance, provider relations, and network management teams to support sustainable, high-quality care delivery for plan members.

Qualifications

• Experience in provider contracting, payor contracting, or network management within a health plan, hospital, or managed care environment.
• Strong skills in negotiation, financial analysis, and contract review, with the ability to interpret reimbursement terms and fee schedules.
• Knowledge of Medicaid, CHIP, and managed care regulations, as well as familiarity with health care delivery systems and provider operations.
• Proficiency in data analysis and reporting tools (e.g., Excel, database systems) and ability to use data to inform contract decisions.
• Excellent written and verbal communication skills, with attention to detail and strong organizational abilities.
• Demonstrated ability to work collaboratively with cross-functional teams and build effective relationships with providers and internal stakeholders.
• Bachelor’s degree in Business, Health Administration, Finance, or a related field; advanced degree or professional certification in healthcare management is a plus.
• Prior experience in a managed care organization in Texas or similar market and familiarity with Texas Medicaid/CHIP programs is highly beneficial.