Strategic Network Contracting Lead

CareMore Health Management Services, LLC; California; Hybrid; USD 98,000 - 147,000; Full time

Job summary

CareMore Health Management Services, LLC is seeking a Senior Network Contracting Analyst to lead complex physician and specialist contracting initiatives that support Medicare Advantage, Medicaid, and other managed care populations.

You will independently manage negotiations, implementation, and administration of provider agreements while delivering strategic financial and market analysis to optimize network performance and value-based care outcomes.

Responsibilities

• Lead negotiations for complex provider agreements through strategy, lifecycle, and execution.
• Develop negotiation strategies using performance, reimbursement, market trends, and quality metrics.
• Interpret financial models to assess reimbursement scenarios and contract economics.
• Structure provider agreements balancing medical costs, network adequacy, quality, and compliance.
• Collaborate with Finance, Legal, Compliance, Provider Ops, Credentialing, and Clinical leadership for implementation.
• Analyze provider network adequacy, access standards, cost trends, utilization, and market opportunities to recommend contracting initiatives and network optimization strategies.
• Serve as primary contracting contact for assigned provider organizations, resolving interpretation issues and reimbursement concerns.
• Support value-based payment arrangements including shared savings, quality incentives, bundles, and capitation.
• Identify contracting risks and opportunities to improve provider performance, member access, and financial sustainability.
• Lead cross-functional contracting projects to enhance governance and data integrity.
• Prepare executive reports and contracting recommendations for Network Management leadership.
• Stay current on CMS regulations and Medicaid requirements affecting provider contracting and reimbursement.
• Foster curiosity about how provider relationships interact with CareMore strategic initiatives.
• Pivot quickly and prioritize workload as organizational objectives evolve.

Job description

CareMore Health Management Services, LLC is seeking a Senior Network Contracting Analyst to lead complex physician and specialist contracting initiatives that support Medicare Advantage, Medicaid, and other managed care populations.

You will independently manage negotiations, implementation, and administration of provider agreements while delivering strategic financial and market analysis to optimize network performance and value-based care outcomes.