Strategic ACO Contract Manager

This is a fully remote position, open to applicants in Arizona, +16 more states.

📋 Description

• Develop and oversee provider networks that meet competitive geographic coverage, stability, unit-cost performance, and trend-management targets.

• Create affordable and predictable networks for both customers and business partners.

• Review and negotiate provider contracts in accordance with company templates, reimbursement standards, and procedural controls.

• Build and sustain relationships with hospitals, physicians, pharmacies, and ancillary providers.

• Ensure an appropriate distribution of provider specialties within networks.

• Negotiate and draft provider contract terms that align with financial objectives and standard agreements.

• Manage contract renewals, amendments, critical dates, and the entire contract lifecycle.

• Keep contractual language and fee schedules updated in line with medical policy changes and reimbursement structures.

• Handle provider relations, resolve issues, and lead processes for dispute resolution.

• Evaluate assigned network and provider performance, identifying opportunities for improvement.

• Support network adequacy, recruitment of providers, and marketing activities for providers.

• Perform additional duties as assigned.

⛳️ Requirements

• Bachelor's degree or equivalent experience in a related field.

• 8 years of relevant work experience beyond the degree.

• Experience in negotiating contracts utilizing Value-Based and ACO arrangements.

• Proven ability to build relationships and establish trust at all organizational levels.

• Experience in health plan operations and/or provider operations.

• Exceptional written, verbal, and presentation skills.

• Demonstrated success in cultivating and maintaining effective, collaborative external relationships.

• Successful experience in contract negotiation for healthcare services, providers, or health plans.

• Flexibility and creativity in developing effective contracting terms.

• Knowledge of provider contracting components and strategies, including risk-based contracting, financial models, operational impact, and data analytics.

• Understanding of complex financial arrangements and quality programs across healthcare products.

• Strong financial, analytical, and problem-solving capabilities.

• Familiarity with legal documents.

• Strategic thinking skills with the ability to analyze complex scenarios.

• Primary residence in a state where Medica is registered as an employer: AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, or WI.

• Legally authorized to work in the United States; Medica does not provide work visa sponsorship.

🏝️ Benefits

• Competitive medical, dental, and vision benefits.

• Paid time off (PTO).

• Holidays.

• Paid volunteer time off.

• 401(k) contributions.

• Caregiver services.

• Incentive plan compensation may be available in addition to base salary.