Hybrid Provider Contract Manager

at CareSource

• Job title: Provider Contract Manager
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $70,800 - $113,200 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, United States

About the role

• Provider Contract Manager supporting the Director in developmental and management tasks for healthcare provider contracting operations while ensuring operational effectiveness and collaboration.

Responsibilities

• Support the Director, Provider Contracting & Strategic Growth with the development, implementation, and management of provider contracting operations processes
• Ensure operational effectiveness by assisting in strategic and business planning, including strategic initiative identification and resource planning and allocation
• Partner with leadership to determine and prioritize opportunities to achieve departmental and enterprise goals
• Participate in provider contract template development
• Provide proactive support, oversight, and management of Preferred, Acceptable, Discouraged, and Unacceptable (PADU) tool and Contract Review Committee (CRC)
• Collaborate with internal business areas on contract negotiations to understand and mitigate operational impacts
• Act as a provider contract management system subject matter expert including but not limited to facilitating user training, contract template management, system troubleshooting, and business requirements
• Facilitate in the development, implementation, and monitoring of departmental policies and procedures
• Support activities as assigned in relation to business development
• Recognize and proactively manage operational dependencies and risks across strategic initiatives and process improvements
• Participate in the process of estimating initiative budgets as well as developing business cases and tracking the benefits realization
• Develop and maintain an in-depth knowledge of the company’s business and regulatory environments

Requirements

• Bachelor’s degree in a healthcare related field, or equivalent years of relevant work experience is required
• Master’s Degree or equivalent work experience is preferred
• Minimum of three (3) years of healthcare experience, to include one (1) year of work experience in managed care provider relations or provider contracting
• Minimum of three (3) years of experience in leading business initiatives to drive systemic change is preferred
• Managed care experience is highly preferred
• Proficient in Microsoft Office Suite (Outlook, Teams, Word, Excel, PowerPoint, and SharePoint)
• Experience with Visio is a plus
• Advanced-level knowledge of provider contracting processes and operations
• Working knowledge of complex provider organizational structures including but not limited to Accountable Care Organizations (ACOs), Clinically Integrated Networks (CIN), and Independent Practice Associations (IPAs)

Benefits

• Comprehensive total rewards package
• Bonuses tied to company and individual performance