Provider Contract Manager

The Provider Contract Manager is responsible for overseeing and guiding the Network Services team which is responsible for the development, maintenance, and optimization of contracted network providers. This role ensures that financial goals related to facility and provider contracting are met, enhances provider satisfaction, and ensures compliance with all state, federal, and accreditation standards. The Provider Contract Manager also presents complex contract analyses to senior leadership, contributing to strategic decision-making.

Key Skills and Abilities:

• Strong negotiation and contract management skills.

• Proficiency in analyzing financial impact of contracts and reimbursement rates.

• Excellent verbal and written communication skills.

• Ability to manage multiple priorities in a fast-paced environment.

• Proficiency in MS Office applications (Word, Excel).

• High level of interpersonal skills to handle sensitive and confidential situations.

• Strong planning and coordination skills.

• Ability to travel as required for provider engagement and network development.

Key Functions:

• Oversee and mentor the Contracting team, providing daily guidance, support, and development.

• Ensure financial goals of Hometown Health are met by managing contracts with providers and facilities, negotiating favorable terms, and ensuring compliance with budgetary objectives.

• Conduct complex contract analyses, presenting findings, insights, and recommendations to senior leaders.

• Partner with other leaders and teams across the organization to enhance internal processes and optimize the provider experience.

• Lead or contribute to cross-functional initiatives aimed at streamlining workflows, improving communication, and increasing efficiency.

Measures of Success:

• Meeting financial goals related to facility and provider contracting.

• Enhancing provider satisfaction.

• Ensuring compliance with all state, federal, and accreditation standards.

• Successful presentation of complex contract analyses to senior leadership.

• Effective collaboration with other departments to achieve business results.

This position does not provide patient care.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Name

Description

Education:

Must have working-level knowledge of the English language, including reading, writing, and speaking English. Bachelor’s degree in business, healthcare administration, or related field from an accredited college or university, or equivalent experience.

Experience:

Minimum of 5 years of experience in contract negotiation.

Proven leadership experience, with a strong background in mentoring and guiding teams.

Demonstrated ability to perform complex contract analyses and present findings effectively to senior leaders.

Strong interpersonal skills with the ability to work collaboratively across departments.

Excellent communication skills, both verbal and written.

Analytical mindset with a solution-oriented approach to problem-solving.

Preferred Skills:

• 5 years’ experience in network management, provider relations, or healthcare contracting.

• Advanced knowledge of healthcare contracting and provider networks.

• Proficiency in data analysis tools and reporting software.

• Knowledge and expertise in Tapestry, state, and federal insurance regulations, and NCQA standards.

License(s):

Ability to obtain and maintain a valid State of Nevada driver's license and ability to pass Renown Health's Department of Motor Vehicle Report criteria.

Certification(s):

None

Computer / Typing:

Must be proficient in Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams and Word and have the ability to use the computer for online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.