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Medica

Provider Contracting Manager III

Medica, Hopkins, Minnesota, United States, 55305

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Contracting Manager III Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We’re a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

Key Accountabilities

Contract Lifecycle and Management

Negotiate terms with providers, ensuring they align with Medica's financial goals and standard template agreements.

Track critical dates, manage the renewal process, and handle amendments as needed.

Keep contractual language and fee schedules up-to-date with current medical policy changes and reimbursement structures.

Oversee all stages of the contract lifecycle: from initiation and negotiation through execution, monitoring, and closure.

Provider Relationships and Network Management

Build and maintain relationships with providers, including key contracting entities.

Resolve issues, manage provider relations, and lead dispute resolution processes.

Conduct regular performance assessments to identify areas for improvement.

Support network growth through activities related to adequacy, provider recruitment, and marketing for providers.

Required Qualifications

Bachelor's degree or equivalent experience in a related field

5 years of work experience beyond degree in contract negotiations and healthcare

Skills and Abilities

WI market knowledge preferred

Basic health plan operations and/or provider operations experience

Excellent communication (written, verbal, and presentation) skills

Proven track record of cultivating and maintaining effective, collaborative external relationships where the parties trust information that’s conveyed

Successful contract negotiation for health care services, provider or health plan

Flexibility and creativity in developing effective contracting terms

Knowledge of provider contracting components and strategies such as 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, and understanding of legal documents

Strategic-thinking skills with the ability to conceptualize a wide range of scenarios and analyze each to come up with the most viable option

Location and Schedule This position is an office role that requires an employee to work onsite at our Madison, WI office or Minnetonka, MN, on average, 3 days per week.

Compensation and Benefits The full salary grade for this position is $77,100 - $132,200. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $77,100 - $115,710. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, holidays, paid volunteer time off, 401(k) contributions, caregiver services and many other benefits to support our employees.

Eligibility to Work in the US Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

Equal Opportunity Employer Statement We are an equal opportunity employer where all qualified candidates receive consideration for employment regardless of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

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