Discover and apply for Senior Provider Network Contracting Manager jobs, a pivotal leadership role at the intersection of healthcare strategy, finance, and relationship management. These professionals are the architects of a healthcare organization's provider network, responsible for building and maintaining the critical relationships with physicians, hospitals, and other healthcare entities that ensure member access to quality care. Their work directly impacts a company's financial viability, market competitiveness, and regulatory compliance. A Senior Provider Network Contracting Manager typically oversees the end-to-end contracting lifecycle. This involves strategically identifying and recruiting providers to fill network gaps, leading complex fee-for-service and value-based contract negotiations, and executing agreements that balance competitive reimbursement rates with cost containment goals. They are adept at analyzing market trends, utilization data, and financial models to develop negotiation strategies. Beyond the initial deal, they manage ongoing provider relationships, addressing service issues, facilitating education on contract terms, and ensuring network adequacy standards are met. Senior managers in this field also often lead a team of contracting specialists, providing mentorship and setting departmental goals. The skill set required for these high-level jobs is multifaceted. Successful candidates possess exceptional negotiation and communication skills, with the ability to influence and build consensus among diverse stakeholders. Strong financial acumen is non-negotiable, as is a deep understanding of healthcare reimbursement methodologies, including DRGs, CPT/HCPCS coding, and capitation. Analytical prowess, with proficiency in spreadsheet and data analysis tools, is essential for modeling contract terms. Typically, employers seek candidates with a bachelor's degree in business, healthcare administration, or a related field (an MBA or MHA is often preferred), coupled with 7+ years of progressive experience in provider contracting, network development, or a related healthcare finance role. Knowledge of regulatory requirements like those from CMS and NCQA is also crucial. For seasoned professionals seeking to leverage their expertise in a strategic capacity, Senior Provider Network Contracting Manager jobs offer a challenging and rewarding career path. These roles are central to shaping the future of healthcare delivery, making them critical positions within health plans, hospital systems, and managed care organizations. Explore opportunities to advance your career in this dynamic field where business strategy meets healthcare mission.
