Provider Contract Negotiation Manager
Core
Negotiates single case agreements for episodes of care, manages dispute resolution and settlements with providers, and ensures contract performance aligns with cost and quality goals.
Role type
Senior individual contributor provider contract negotiation manager
Builds
Negotiated provider contracts and settlement agreements for episodes of care
Domain
Health insurance / Provider relations
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Provider contracting, claims management, patient management, cost-saving initiatives, dispute resolution, process improvement, cross-functional collaboration, coaching
Preferred skills
National Advantage Program knowledge, Aetna systems proficiency (Smart Front End, ASD, HRP, MedCompass, RUMBA)
Technologies
ACAS, HRP, Smart Front End, ASD, MedCompass, RUMBA
Responsibilities
Negotiate single case agreements for episodes of care; Analyze forecast changes and develop business impact assessments; Determine recommendations to manage cost issues; Develop and maintain relationships with physicians/providers; Coach junior colleagues on negotiation techniques; Collaborate cross-functionally to manage negotiations
Seniority
Senior, hands-on IC
