Senior Provider Network Manager

Jobtailor; Los Angeles (CA); On-site; USD 110,000 - 170,000; Full time

Job summary

Jobtailor in Los Angeles, CA is seeking a seasoned Contracting and Provider Relations professional to build and optimize a robust provider network through strategic negotiations, relationship development, and comprehensive servicing across multiple markets. You will manage complex fee schedules and non-standard arrangements with a focus on value-based concepts.

The role requires leadership to mentor staff, collaborate with sales teams for employer-group presentations, and ensure accurate

Qualifications

• BA/BS degree required.
• Minimum 5 years’ experience in contracting, provider relations, and servicing.
• Experience should include prior contracting experience.
• California provider experience preferred.

Responsibilities

• Develop the provider network through contract negotiations, relationship development, and servicing.
• Focus on contracting and negotiating contract terms with complex providers.
• Work with large institutional providers, large medical groups, ancillary providers, and value-based concepts.
• Negotiate non-standard arrangements and customized fee schedules.
• Serve as a key resource for contracting staff.
• Provide mentoring and on-the-job training and development.
• Work independently with a high level of judgment and discretion.
• Collaborate on business-unit and enterprise network-management projects.
• Collaborate with sales teams on presentations to employer groups.
• Serve as a communication link between professional providers and the company.
• Ensure appropriate distribution of provider specialties in the network.
• Conduct complex negotiations and draft documents.
• Prepare financial projections and conduct analysis.

Skills

Contract Negotiation

Provider Relations

Fee Schedule Development

Actuarial Models

Document Drafting

Education

BA/BS degree

Job description

Job Responsibilities

• Develop the provider network through contract negotiations, relationship development, and servicing
• Focus on contracting and negotiating contract terms with complex providers
• Work with large institutional providers, large medical groups, ancillary providers, and value-based concepts
• Negotiate non-standard arrangements and customized fee schedules
• Serve as a key resource for contracting staff
• Provide mentoring and on-the-job training and development
• Work independently with a high level of judgment and discretion
• Collaborate on business-unit and enterprise network-management projects
• Collaborate with sales teams on presentations to employer groups
• Serve as a communication link between professional providers and the company
• Ensure appropriate distribution of provider specialties in the network
• Conduct complex negotiations and draft documents
• Prepare financial projections and conduct analysis

Requirements

• Requires a BA/BS degree
• Minimum of 5 years’ experience in contracting, provider relations, provider servicing
• Experience should include prior contracting experience
• Any combination of education and experience providing an equivalent background
• Must have California provider experience
• Experience in fee schedule development using actuarial models strongly preferred
• Must have ability to work Pacific Standard Time hours
• Travels to worksite and other locations as necessary
• Must reside within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law

Core Competencies

Demonstrates expertise in contract negotiations and provider relations, with a strong focus on developing provider networks and customizing fee schedules. Proven ability to mentor and train staff while collaborating effectively across business units.

Highest-signal resume keywords

• Contract Negotiation
• Provider Relations
• Fee Schedule Development
• California Provider Experience
• Financial Projections

ATS Optimization Keywords

Hard Skills

• Contracting
• Provider Servicing
• Complex Negotiations
• Actuarial Models
• Document Drafting

Soft Skills

• Relationship Development
• Mentoring
• Judgment
• Discretion
• Collaboration

Industry Keywords

• Provider Network
• Value-Based Concepts
• Institutional Providers
• Medical Groups
• Ancillary Providers