Strategic Provider Network Contracting Lead

Center for Elders' Independence; Oakland (CA); On-site; USD 136,000 - 164,000; Full time

Job summary

Center for Elders’ Independence in Oakland, CA seeks a Manager of Contracting to lead provider network contracting and relationships. This full-time role reports to the CFO and oversees contract negotiations, lifecycle, and compliance with DHS/CMS regulations.

The position focuses on reimbursement negotiations, contract development, and education of internal and external partners, with oversight of software systems and policy implementation.

Qualifications

• Requires a bachelor’s degree in health care administration, business administration, finance, public administration, or a related field.
• Requires five years of experience in contract negotiations, fiscal management, or a related field.
• Supervisory or leadership experience preferred.
• Experience in using contract management systems, provider databases, and reporting tools preferred.
• Requires knowledge of Medicare, Medicaid, and commercial reimbursement practices, as well as three years of experience in physician, health care, and vendor contract negotiation and administration.
• Requires familiarity with terms and conditions for services and in-depth knowledge of legal terminology.
• Knowledge of ICD-9, ICD-10, CPT, and HCPCS codes is preferred.
• Proficient in Microsoft Office, including Excel, Word, and PowerPoint; experience with contract management software is preferred.
• Demonstrates excellent written and verbal communication skills, with the ability to communicate clearly, concisely, and effectively at all levels of the organization.
• Demonstrates the ability to plan, organize, and meet deadlines while managing numerous and changing priorities.

Responsibilities

• Leads complex contracting and reimbursement negotiations, including outreach and contract negotiations with provider network and vendors.
• Oversee the contract lifecycle including loading, submissions, and coordination with matrix partners for network implementation and maintenance.
• Ensure that contracts comply with DHS and CMS regulations.
• Ensures departmental compliance with provider roster and credentialing requirements.
• Monitors contracts, enforces contract terms, and ensures renewals and amendments are completed in a timely manner.
• Manage network adequacy in alignment with business needs and regulatory guidelines.
• Leads contract onboarding and education on CEI/PACE requirements.
• Monitors contract performance and support timely issue resolution.
• Oversee the finalization of Letters of Agreement and Memoranda of Understanding.
• Prepares, analyzes, reviews, and projects the fiscal impact of complex contracts, including value-based care and alternative payment arrangements.
• Updates the Provider Manual annually.
• Oversees the accuracy of contracting and purchasing software systems.
• Develops and implements departmental policies and procedures.
• Monitors and reviews departmental duties, compliance, and workflow to ensure policies are implemented with the highest level of efficiency and accuracy.
• Perform supervisory duties, including interviewing, hiring, training employees, assigning work, and supporting staff development.
• Evaluates the performance of direct reports, recommends training, and maintains staff at the level of skill necessary to meet organizational objectives.
• Builds relationships that support external and internal partnerships and identifies broader business opportunities that advance the organization’s strategy.

Skills

Contract negotiations

Fiscal management

Leadership

Provider networks

CMS/Medicare knowledge

Contract management systems

Microsoft Office

Communication skills

Time management

Education

Bachelor’s degree in health care administration, business administration, finance, public administration, or related field

Tools

Excel

Word

PowerPoint

Contract management software

Provider databases

Job description

Center for Elders’ Independence in Oakland, CA seeks a Manager of Contracting to lead provider network contracting and relationships. This full-time role reports to the CFO and oversees contract negotiations, lifecycle, and compliance with DHS/CMS regulations.

The position focuses on reimbursement negotiations, contract development, and education of internal and external partners, with oversight of software systems and policy implementation.