Manager, Provider Contracting (Madison, WI)

Medica is a nonprofit health plan seeking a Manager, Provider Contracting to lead a team in negotiating, managing, and maintaining contracts with providers to ensure financial and regulatory compliance.

Requirements

• Team leadership: Mentor and manage a team of contract managers, guiding them through complex negotiations and ensuring they meet performance goals and deadlines.
• Strategic negotiation: Lead and support contract negotiations with providers to secure favorable terms that support the organization's financial and strategic objectives.
• Contract lifecycle management: Oversee the entire contract lifecycle from initiation, creation, and negotiation to execution, monitoring, and renewal/termination.
• Compliance and regulatory adherence: Ensure all contracts and processes comply with federal, state, and industry standards and legal requirements.
• Financial and operational oversight: Analyze contract performance, monitor key financial metrics like reimbursement rates, and make recommendations for improvement.
• Relationship management: Foster and maintain strategic relationships with provider partners
• Process improvement: Develop and maintain policies, procedures, and templates for contracting. Identify opportunities for internal process improvement and implement new provider programs or payment models.
• Cross-functional collaboration: Liaise with other departments, such as billing, legal, and operations, to ensure accurate implementation and understanding of contract terms.

Benefits

• Competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits