Provider Contract Manager II

Medica

. Develop and maintain provider networks that are competitive, geographically stable, and aligned with unit cost and trend-management objectives .

Posted 10/6/2026full-timeRemote • United StatesMid-LevelSenior💰 $70,200 - $120,400 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in provider contracting, including negotiation strategies, financial analysis, and compliance with legal standards. Proven ability to cultivate relationships and communicate effectively with diverse stakeholders in the healthcare sector.

Highest-signal resume keywords

Contract NegotiationProvider ContractingFinancial AnalysisHealthcare Market KnowledgeRelationship Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Provider Contracting ComponentsRisk-Based ContractingData AnalyticsFinancial ModelsNegotiation Strategies

Soft Skills

Excellent Written CommunicationPresentation SkillsStrategic ThinkingProblem-Solving SkillsCollaboration

Industry Keywords

Healthcare ServicesReimbursement StandardsMarket IntelligenceQuality ProgramsCost-of-Care Initiatives

About the role

Key responsibilities & impact

Develop and maintain provider networks that are competitive, geographically stable, and aligned with unit cost and trend-management objectives
Evaluate network adequacy, market dynamics, provider availability, and provider specialties
Review and negotiate provider contracts, reimbursement structures, and proposed terms
Conduct routine negotiations with physicians, ancillary providers, and smaller facilities
Ensure contracts comply with templates, reimbursement standards, legal requirements, and documentation standards
Analyze financial impacts of proposed contract terms and escalate exceptions
Manage routine provider contract questions, relationships, and escalations
Communicate performance metrics, contract requirements, and network initiatives
Support provider understanding of reimbursement methodologies, operational workflows, and administrative processes
Attend provider meetings and workgroups
Analyze claims, cost, and utilization data to identify patterns affecting contracting decisions
Use market intelligence, benchmarking, and models to develop negotiation strategies, summaries, and recommendations
Track competitor activity and regulatory updates affecting network structure
Recommend improvements to contracting workflows, tools, and documentation
Collaborate with legal, finance, provider operations, and clinical teams to implement contracts
Participate in value-based contracting, quality programs, and cost-of-care initiatives
Share knowledge and best practices with peers

Requirements

What you’ll need

Bachelor's degree or equivalent experience in related field
3+ 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 written, verbal, and presentation skills
Ability to work independently, make sound judgment calls, and determine when escalation is needed
Proven track record cultivating and maintaining effective, collaborative external relationships
Proven track record as a successful contract negotiator for health care services, providers, or health plans
Flexibility and creativity in developing effective contracting terms
Knowledge of provider contracting components and strategies, including risk-based contracting, financial models, operational impact, and data analytics
Demonstrated understanding of complex financial arrangements and quality programs across health care products
Strong financial, analytical, and problem-solving skills
Understanding of legal documents
Strategic-thinking skills and ability to analyze scenarios and determine viable options
Primary home address must be located in a state where Medica is registered as an employer: AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, or WI
Must be legally authorized to work in the United States at the time of application
Medica does not offer work visa sponsorship for this role

Benefits

Comp & perks

Competitive medical, dental, and vision coverage
PTO
Holidays
Paid volunteer time off
401K contributions
Caregiver services
Incentive plan compensation may be available in addition to base salary
Many other benefits to support employees