Provider Contracting Manager III

Medica

. Develop and maintain provider networks yielding a competitive, geographic, stable network that achieves objectives for unit cost performance and trend management .

Posted 4/21/2026full-timeRemote • Arizona, Florida, Illinois, Iowa, Kansas, Kentucky, Minnesota, Missouri, Montana, New York, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Virginia, Wisconsin • 🇺🇸 United StatesMid-LevelSenior💰 $78,700 - $118,020 per yearWebsite

About the role

Key responsibilities & impact

Develop and maintain provider networks yielding a competitive, geographic, stable network that achieves objectives for unit cost performance and trend management
Produces an affordable and predictable network for customers and business partners
Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
Establishes and maintains strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties
Manage contract renewals and amendments: Track critical dates, manage the renewal process, and handle amendments as needed
Oversee the entire contract lifecycle: Manage all stages, from initiation and negotiation through execution, monitoring, and closure
Manage provider relations, address issues, and lead dispute resolution processes
Regularly evaluate the performance of assigned networks and providers to identify areas for improvement
Participate in activities related to network adequacy, provider recruitment, and marketing for providers

Requirements

What you’ll need

Bachelor's degree or equivalent experience in related field
5 years of work experience beyond degree in contract negotiations and healthcare
WI market knowledge within provider contracting
Basic Health plan operations and/or provider operations experience
Excellent communication (written, verbal and presentation) skills
A proven track record as a successful contract negotiator for health care services, provider or health plan
Flexibility and creativity in developing effective contracting terms
Knowledge of provider contracting components and strategies such as but not limited to risk-based contracting, financial models, operational impact and data analytics
Strong financial, analytical and problem solving skills, and understanding of legal documents
Strategic-thinking skills with the ability to conceptualize a wide range of scenarios and the ability to analyze each scenario to come up with the most viable option

Benefits

Comp & perks

competitive medical
dental
vision
PTO
Holidays
paid volunteer time off
401K contributions
caregiver services

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

contract negotiationsprovider contractingrisk-based contractingfinancial modelsdata analyticshealth plan operationsprovider operationscontract lifecycle managementperformance evaluationdispute resolution

Soft Skills

communicationflexibilitycreativityanalytical skillsproblem solvingstrategic thinkingrelationship managementpresentation skillsnegotiation skillsleadership

Certifications

Bachelor's degree