Remote Provider Contract Manager II

Medica; Minnetonka (MN); Remote; USD 70,000 - 120,000; Full time

Benefits offered by this job

Remote work

Competitive benefits

Paid time off

401K

Job summary

Medica is a nonprofit health plan serving multiple states. The Contract Manager II role focuses on intermediate-level contracting, analysis, and provider relationships to build a compliant, cost-effective network.

You will evaluate network adequacy, conduct routine negotiations, and manage contracting workflows with moderate independence. Collaborate across legal, finance, provider operations, and clinical teams to implement contracts, support value-based initiatives, and improve cost of care

Qualifications

• Bachelor's degree or equivalent experience in related field.
• 3+ years of work experience beyond degree in contract negotiations and healthcare.
• WI market knowledge within provider contracting.

Responsibilities

• Review proposed terms, reimbursement structures, and negotiation considerations in alignment with company standards.
• Conduct negotiations with physicians, ancillary providers, and smaller facilities to reach compliant agreements.
• Ensure contracts follow approved templates, legal requirements, and documentation standards.
• Analyze financial impacts of proposed terms and elevate exceptions as needed.
• Serve as the primary point of contact for routine contract questions and manage provider relationship and escalations.
• Communicate performance metrics, contract requirements, and network initiatives effectively.
• Support provider understanding of reimbursement methodologies, operational workflows, and administrative processes.
• Attend provider meetings or workgroups to build positive, collaborative relationships.
• Analyze claims, cost, and utilization data to detect patterns affecting contracting decisions.
• Use market intel and benchmarking to support negotiation strategy development.
• Utilize and edit models to prepare summaries or recommendations for internal review.
• Track competitor activity and regulatory updates that may impact network structure.
• Suggest enhancements to contracting workflows, tools, or documentation processes.
• Collaborate with legal, finance, provider operations, and clinical teams to implement contracts smoothly.
• Participate in initiatives such as valuebased contracting, quality programs, or costofcare efforts.
• Share knowledge and best practices with peers to strengthen team capabilities and consistency.

Skills

Provider contracting knowledge

Negotiation skills

Analytical thinking

Communication skills

Education

Bachelor's degree or equivalent experience in related field

Job description

Medica is a nonprofit health plan serving multiple states. The Contract Manager II role focuses on intermediate-level contracting, analysis, and provider relationships to build a compliant, cost-effective network.

You will evaluate network adequacy, conduct routine negotiations, and manage contracting workflows with moderate independence. Collaborate across legal, finance, provider operations, and clinical teams to implement contracts, support value-based initiatives, and improve cost of care