Senior PN Contract Manager - St Louis, Missouri Market

Medica; Minnetonka (MN); Remote; USD 87,000 - 150,000; Full time

Job summary

An established industry player is seeking a Senior Provider Network Contract Manager to develop and maintain competitive provider networks that align with the Quadruple Aim. This fully remote role emphasizes building strong relationships with providers and negotiating contracts that meet organizational standards. The ideal candidate will leverage their extensive experience in provider contracting and negotiation to drive performance improvements and achieve value-based care goals. Join a forward-thinking company that values innovation and offers a comprehensive benefits package, making it an exciting opportunity for professionals in the healthcare sector.

Benefits

Health Insurance

Dental Insurance

Vision Insurance

PTO

401K

Holidays

Incentive Compensation

Qualifications

• 7+ years of experience in provider contracting.
• Experience with value-based care models and contracting methodologies.

Responsibilities

• Develop and maintain provider networks for competitive solutions.
• Evaluate and negotiate contracts to ensure compliance and performance.

Skills

Negotiation Skills

Provider Relationship Management

Financial Analysis

Legal Contract Understanding

Communication Skills

Problem-Solving Skills

Presentation Skills

Workload Management

Education

Bachelor's Degree in Related Field

Job description

Senior Provider Network Contract Manager

Develops and maintains provider networks to ensure a competitive and stable network solution that advances the objectives of the Quadruple Aim. Produces an affordable and predictable network for customers and business partners, differentiating from other market offerings. Identifies strategic opportunities with providers and establishes a trusted, strategic relationship environment through interest-based management. Leverages data to identify collaboration opportunities for performance improvement across key metrics with provider partners. Evaluates and negotiates contracts in compliance with company standards, reimbursement structures, and process controls. Builds and maintains strong relationships with Hospital, Physician, Pharmacy, and Ancillary providers, ensuring appropriate network composition, with a focus on expanding in the St Louis market.

This is an advanced professional position providing guidance to staff and performing responsibilities with minimal supervision.

Qualifications:

• Bachelor's degree or equivalent experience in a related field
• 7+ years of experience in provider contracting
• Experience with various contracting methodologies and value-based/total-cost-of-care models

Skills and Abilities:

• Successful negotiation skills to achieve value-based care goals, including risk-based agreements with quality and cost metrics
• Ability to develop and maintain long-term provider relationships through regular engagement
• Experience in provider contract interpretation and provider value-based financial analysis
• Strong financial, analytical, and legal contract understanding skills
• Excellent communication skills, both written and verbal, including presentation skills
• Ability to translate complex system capabilities into clear messages
• Problem-solving skills with ability to identify root causes and implement corrective actions
• Self-motivated with the ability to drive team commitments
• Experience managing workload in deadline-driven environments
• Experience presenting to senior leadership and working across organizational levels
• Experience setting up reporting and monitoring systems for contracts
• Ability to facilitate information sharing within clinically integrated networks

This role is fully remote, requiring candidates to reside in states where Medica is registered: AR, AZ, FL, GA, IA, IL, KS, KY, MD, ME, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI.

The salary range is $87,100 - $149,300, with placement based on education, experience, certifications, scope, and market data. Additional incentive compensation may be available. Medica offers a comprehensive benefits package including health, dental, vision, PTO, holidays, 401K, and more.

Medica is an Equal Opportunity Employer, considering all qualified candidates regardless of protected characteristics. For more information, see the Know Your Rights notice from the Department of Labor.