CareSource
Provider Contract Manager – R11058
– CareSource
Job Summary
The Provider Contract Manager supports the Director, Provider Contracting & Strategic Growth with the development, implementation, and management of provider contracting operations processes.
Essential Functions
Ensure operational effectiveness by assisting in strategic and business planning, including strategic initiative identification, resource planning and allocation
Partner with leadership to determine and prioritize opportunities to achieve departmental and enterprise goals
Participate in provider contract template development
Provide proactive support, oversight, and management of Preferred, Acceptable, Discouraged, and Unacceptable (PADU) tool and Contract Review Committee (CRC)
Collaborate with internal business areas on contract negotiations to understand and mitigate operational impacts
Act as a provider contract management system subject‑matter expert including facilitation of user training, contract template management, system troubleshooting, and business requirements
Facilitate the development, implementation, and monitoring of departmental policies and procedures
Support activities as assigned in relation to business development
Recognize and proactively manage operational dependencies and risks across strategic initiatives and process improvements
Participate in the estimation of initiative budgets as well as the development of business cases and tracking of benefits realization
Develop and maintain an in-depth knowledge of the company’s business and regulatory environments
Perform any other job duties as requested
Education And Experience
Bachelor’s degree in a healthcare‑related field, or equivalent years of relevant work experience (required)
Master’s Degree or equivalent work experience (preferred)
Minimum of three (3) years of healthcare experience, including one (1) year of managed‑care provider relations or provider contracting
Minimum of three (3) years of experience leading business initiatives to drive systemic change (preferred)
Managed‑care experience highly preferred
Competencies, Knowledge And Skills
Proficient in Microsoft Office Suite (Outlook, Teams, Word, Excel, PowerPoint, SharePoint); Visio experience a plus
Effective identification of business problems, assessment of proposed solutions, and understanding of business partner needs
Advanced knowledge of provider contracting processes and operations
Working knowledge of complex provider organizational structures including ACOs, CINs, and IPAs; excellent written and verbal communication and interaction skills
Effective problem‑solving, critical thinking, and listening skills
Ability to manage and prioritize multiple tasks, promote teamwork, and make fact‑based decisions
Licensure And Certification
None
Working Conditions
General office environment; may be required to sit or stand for extended periods of time
Reasonable travel, up to 15% as required to fulfill duties
Compensation Range
$70,800.00 – $113,200.00. CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well‑being and offer a substantial and comprehensive total rewards package.
Compensation Type
Salary
Competencies
Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business
CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
Seniority Level
Mid‑Senior level
Employment Type
Full‑time
Job Function
Management and Manufacturing
Industries
Insurance
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– CareSource
Job Summary
The Provider Contract Manager supports the Director, Provider Contracting & Strategic Growth with the development, implementation, and management of provider contracting operations processes.
Essential Functions
Ensure operational effectiveness by assisting in strategic and business planning, including strategic initiative identification, resource planning and allocation
Partner with leadership to determine and prioritize opportunities to achieve departmental and enterprise goals
Participate in provider contract template development
Provide proactive support, oversight, and management of Preferred, Acceptable, Discouraged, and Unacceptable (PADU) tool and Contract Review Committee (CRC)
Collaborate with internal business areas on contract negotiations to understand and mitigate operational impacts
Act as a provider contract management system subject‑matter expert including facilitation of user training, contract template management, system troubleshooting, and business requirements
Facilitate the development, implementation, and monitoring of departmental policies and procedures
Support activities as assigned in relation to business development
Recognize and proactively manage operational dependencies and risks across strategic initiatives and process improvements
Participate in the estimation of initiative budgets as well as the development of business cases and tracking of benefits realization
Develop and maintain an in-depth knowledge of the company’s business and regulatory environments
Perform any other job duties as requested
Education And Experience
Bachelor’s degree in a healthcare‑related field, or equivalent years of relevant work experience (required)
Master’s Degree or equivalent work experience (preferred)
Minimum of three (3) years of healthcare experience, including one (1) year of managed‑care provider relations or provider contracting
Minimum of three (3) years of experience leading business initiatives to drive systemic change (preferred)
Managed‑care experience highly preferred
Competencies, Knowledge And Skills
Proficient in Microsoft Office Suite (Outlook, Teams, Word, Excel, PowerPoint, SharePoint); Visio experience a plus
Effective identification of business problems, assessment of proposed solutions, and understanding of business partner needs
Advanced knowledge of provider contracting processes and operations
Working knowledge of complex provider organizational structures including ACOs, CINs, and IPAs; excellent written and verbal communication and interaction skills
Effective problem‑solving, critical thinking, and listening skills
Ability to manage and prioritize multiple tasks, promote teamwork, and make fact‑based decisions
Licensure And Certification
None
Working Conditions
General office environment; may be required to sit or stand for extended periods of time
Reasonable travel, up to 15% as required to fulfill duties
Compensation Range
$70,800.00 – $113,200.00. CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well‑being and offer a substantial and comprehensive total rewards package.
Compensation Type
Salary
Competencies
Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business
CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
Seniority Level
Mid‑Senior level
Employment Type
Full‑time
Job Function
Management and Manufacturing
Industries
Insurance
#J-18808-Ljbffr