Senior Contracting & Provider Relations Manager
Posted
Description
How You Will Contribute
Provider Contracting & Relationship Management
- Lead complex negotiations with prospective and existing providers to achieve cost, quality, access, and performance objectives.
- Serve as a senior point of contact for managed providers, guiding contract interpretation, implementation, and ongoing relationship management.
- Oversee execution and maintenance of provider agreements that incorporate advanced value-based payment methodologies, including total cost of care, shared savings, and performance metrics.
- Ensure provider agreements align with organizational strategy, reimbursement intent, and operational execution.
Strategic Contracting, Complexity Management & Market Leadership
- Define and articulate the strategic importance of managing complexity in provider contracting, reimbursement design, and market decision-making.
- Integrate complex information across the organization to inform high-impact strategic contracting decisions.
- Leverage sophisticated analytical frameworks to interpret multifaceted financial, operational, and performance data.
- Identify systemic issues and strategic opportunities within complex healthcare environments, leading coordinated organizational responses.
- Engage senior leaders and external stakeholders to collaboratively navigate complex challenges and advance strategic initiatives.
- Represent The Alliance in high-stakes provider, employer, and community discussions, offering insights grounded in comprehensive analysis.
- Inspire innovative problem-solving approaches that embrace complexity, uncertainty, and continuous improvement.
Nimble Learning, Experimentation & Continuous Improvement
- Apply a structured, disciplined approach to experimentation in contracting strategies, reimbursement models, and provider engagement.
- Use both successes and failures as meaningful data points to refine strategies and improve outcomes.
- Analyze patterns from prior initiatives and experiments to inform future decisions and anticipate impacts.
- Regularly engage in iterative cycles of learning, making targeted adjustments to enhance performance and results.
- Demonstrate resilience, flexibility, and adaptability when responding to evolving market dynamics and organizational priorities.
- Share lessons learned across teams and mentor others in using experimentation and learning as tools for growth and innovation.
Collaboration, Influence & Communication
- Partner closely with Business Development to align provider contracting strategies with employer value propositions and participate in employer-facing discussions as needed.
- Build and sustain strong relationships with providers, employers, brokers, and community partners to support market credibility and strategic alignment.
- Synthesize market intelligence and performance insights to strengthen The Alliance’s provider value proposition.
- Represent The Alliance in regional healthcare forums, provider meetings, and community events, serving as a trusted senior leader and ambassador.
Your Qualifications
- Bachelor’s degree (B.A. or B.S.) in a relevant field, or an equivalent combination of education and experience.
- Minimum of 5 years of progressive experience in healthcare, insurance, or provider contracting, with demonstrated senior-level responsibility.
- Advanced expertise in reimbursement methodologies, including Medicare-based contracting, capitation, total cost of care, and value-based payment models.
- Proven success leading complex provider negotiations and managing high-impact provider relationships.
- Expert-level capability in managing complexity across multiple markets, stakeholders, and contracting models.
- Advanced financial acumen, including experience developing and interpreting financial models, proformas, and performance metrics to inform contracting decisions.
- Strong understanding of hospital systems, physician organizations, and healthcare delivery structures.
- Advanced communication, decision-making, and accountability skills, with the ability to build trust and influence senior provider and employer stakeholders.
- Proficiency in Microsoft Office tools, including Word, Excel, and database applications.
Stand-Out From the Crowd Qualifications
- Experience leading regional provider network strategies or market-based contracting initiatives.
- Demonstrated ability to operate as a strategic thought partner to executive leaders.
- Demonstrated agility and nimble learning in evolving reimbursement, market, and organizational environments.
Physical Aspects of the Job
- Prolonged periods of sitting, working on a computer, and participating in virtual and in-person meetings.
- Frequent use of hands and fingers for documentation, data analysis, and communication.
- Ability to communicate clearly and effectively in person, virtually, and in writing.
- Occasional lifting or carrying of materials up to 10 pounds.
- Regular regional travel required for provider meetings, employer presentations, and community engagement.