Job OverviewThe position plays a key role in developing and managing a high-performing, cost-effective, and compliant provider network. This position is responsible for negotiating, executing, maintaining contracts and relationships, and overseeing complex contracts (i.e., Primary Care Physician (PCP), specialist, ancillary providers, hospitals), ensuring alignment with regulatory standards and organizational objectives. Leads initiatives to expand the provider network, supports strategic growth in managed care, and contributes to financial performance goals. This role also involves mentoring junior staff, enhancing provider relationships, and driving efforts to secure new partnerships while maintaining strong collaboration with existing providers and clients.
Minimum Requirements- Bachelor's degree in a related field with 4 years of relevant experience (i.e., provider contracting, contract interpretation, negotiation, client relations) or 5+ years of relevant experience in lieu of a degree.
- Experience with Medicaid, Medicare Advantage, or Commercial provider networks required.
- Proficiency with contract lifecycle management systems and provider databases required.
- Knowledge of provider reimbursement methodologies (e.g., fee-for-service, capitation, value-based models) required.
- Familiarity with healthcare regulatory requirements (e.g., CMS, DHCS, DMHC, NCQA) related to provider networks is required.
- Experience with reviewing and negotiating contract language to ensure compliance with standards and regulatory requirements is required.
- Healthcare experience in managed care, or with a physician group, clinical-based organization, and/or in a hospital/facility setting preferred.
Compensation$88,641.28 - $110,801.60 annually
Compensation DisclaimerActual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.
Benefits & Career Development- Medical, Dental and Vision insurance
- 403(b) Retirement savings plans with employer matching contributions
- Flexible Spending Accounts
- Commuter Flexible Spending
- Career Advancement & Development opportunities
- Paid Time Off & Holidays
- Paid CME Days
- Malpractice insurance and tail coverage
- Tuition Reimbursement Program
- Corporate Employee Discounts
- Employee Referral Bonus Program
- Pet Care Insurance
