Senior Network Contracting Negotiation Manager, Medicaid (Michigan)
Core
Negotiate, execute, and manage complex provider contracts for Medicaid products, focusing on rate analysis, dispute resolution, and network expansion to meet accessibility and financial goals.
Role type
Senior Network Contracting Negotiation Manager
Builds
Provider networks and value-based contract relationships for Medicaid products
Domain
Healthcare / Medicaid / Provider Contracting
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Provider negotiation, contract analysis, dispute resolution, cost management, network expansion, strategic relationship management, regulatory compliance, financial modeling, cross-functional collaboration, critical thinking
Preferred skills
Value-based contracting knowledge, Medicaid expertise, provider financial strategy understanding, competitor strategy analysis, internal system knowledge
Technologies
Microsoft Office/Excel
Responsibilities
Negotiate and execute provider contracts with complex hospital systems and physician groups; conduct rate analysis and dispute resolution; recruit providers to meet network adequacy targets; manage cost issues and initiate cost-saving initiatives; represent the company with high-visibility constituents; optimize interactions with providers and internal partners; participate in JOC meetings; manage contract performance and support value-based contract implementation; serve as SME for team members; ensure resolution of escalated claims and contract interpretation issues.
Seniority
Senior, hands-on IC