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Provider Contract Jobs (NOW HIRING)

paradigm

Provider Contract Manager

Houston, TX

$85K - $113K/yr

The Provider Contract Manager will grow and enhance Paradigm's Provider Network by negotiating contracts, amendments, establishing and maintaining relationships with providers to secure network ...

Paradigm

Provider Contract Manager

Tampa, FL · On-site

$100K - $120K/yr

The Provider Contract Manager will grow and enhance Paradigm's Provider Network by negotiating contracts, amendments, establishing and maintaining relationships with providers to secure network ...

Capital Blue Cross

Provider Contract Manager

Harrisburg, PA · On-site

$87K - $117K/yr

The individual is accountable for executing contract negotiations, driving provider network strategy, and implementing innovative reimbursement models, including value-based programs and risk ...

EmblemHealth

Provider Contract Specialist

New York, NY · On-site

$56K - $99K/yr

Responsibilities * Assist providers in all matters related to contract disputes and ensure accurate contract and rate load implementations are done in a timely manner. * Communicate with providers ...

paradigm

Provider Contract Manager

Chicago, IL · On-site

$91K - $122K/yr

The Provider Contract Manager will grow and enhance Paradigm's Provider Network by negotiating contracts, amendments, establishing and maintaining relationships with providers to secure network ...

paradigm

Senior Provider Contract Specialist

Tampa, FL · On-site

$93K/yr

... contracts as well as other paperwork to physicians and other types of providers. * Follow up with providers regarding full participation and secure participation agreements. * Update proprietary ...

Paradigm

Senior Provider Contract Specialist

Tampa, FL · On-site

$38 - $45/hr

... contracts as well as other paperwork to physicians and other types of providers. * Follow up with providers regarding full participation and secure participation agreements. * Update proprietary ...

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Provider Contract information

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$10

$31

$98

How much do provider contract jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for provider contract in the United States is $31.82, according to ZipRecruiter salary data. Most workers in this role earn between $14.90 and $28.37 per hour, depending on experience, location, and employer.

What is a Provider Contract?

A provider contract is a formal agreement between a healthcare provider, such as a doctor or hospital, and a health insurance company or managed care organization. This contract outlines the terms under which the provider will deliver medical services to insured members, including reimbursement rates, covered services, and billing procedures. Provider contracts help ensure that patients receive agreed-upon care at predetermined costs and establish the responsibilities of both the provider and the insurer. These agreements are essential for maintaining a network of healthcare professionals who serve plan members.

What is the difference between Provider Contract vs Medical Billing Specialist?

AspectProvider ContractMedical Billing Specialist
CredentialsTypically requires healthcare administration, legal, or business certificationsRequires coding, billing, and healthcare reimbursement certifications
Work EnvironmentHealthcare facilities, insurance companies, or legal officesMedical offices, billing companies, or healthcare providers
Industry UsageUsed in healthcare contracting, negotiations, and legal agreementsUsed in processing insurance claims and patient billing

While Provider Contract specialists focus on creating and managing agreements between healthcare providers and payers, Medical Billing Specialists handle the coding and submission of claims for reimbursement. Both roles are essential in healthcare finance but serve different functions within the revenue cycle.

What are some common challenges faced by professionals in provider contract roles, and how can they be addressed?

Professionals in provider contract roles often encounter challenges such as navigating complex regulatory requirements, ensuring contract compliance, and balancing the interests of both healthcare providers and payers. Additionally, they may need to negotiate terms that are both competitive and sustainable for their organization. These challenges can be addressed by staying up-to-date with industry regulations, developing strong negotiation and communication skills, and fostering collaborative relationships with internal legal, compliance, and finance teams.

What are the key skills and qualifications needed to thrive as a Provider Contract Specialist, and why are they important?

To excel as a Provider Contract Specialist, you need strong analytical abilities, knowledge of healthcare regulations, contract negotiation skills, and typically a bachelor's degree in business, healthcare administration, or a related field. Familiarity with contract management software, healthcare reimbursement systems, and proficiency in Microsoft Office are commonly required. Excellent attention to detail, communication, and relationship-building skills help you collaborate effectively with providers and internal stakeholders. These competencies ensure accurate contract execution, regulatory compliance, and mutually beneficial agreements in a complex healthcare environment.
What cities are hiring for Provider Contract jobs? Cities with the most Provider Contract job openings:
What are the most commonly searched types of Provider jobs? The most popular types of Provider jobs are:
What states have the most Provider Contract jobs? States with the most job openings for Provider Contract jobs include:
Provider Contract jobs near you
Provider Contract Specialist

Provider Contract Specialist

EmblemHealth

New York, NY

Other

Posted 19 days ago

EmblemHealth rating

9.4

Company rating: 9.4 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

9th of 281 rated insurance

Job description

Summary of Job

Act as a liaison and operate as a vital link between specific Facility, Ancillary, Delegated and/or Professional providers and EmblemHealth.  Responsible for day-to-day operations for all activities related to contracts with minimal supervision and direction, contract optimization, implementation of new programs and to assist with provider issues, education materials, as well as communication of Plan policies and procedures.  Contact for all escalated issues from the Provider and internal EmblemHealth departments, including grievances, disputes, and provider/member billing complaints.  Note: the term "Provider" can include managing entity for health systems, facilities such as a specialty office, large faculty and group practices, delegated relationships, ancillary or ambulatory centers and the like.

Responsibilities

  • Assist providers in all matters related to contract disputes and ensure accurate contract and rate load implementations are done in a timely manner.
     
  • Communicate with providers and respond to provider inquiries in a timely, accurate, and professional manner with minimal direction from leadership.
     
  • Support the timely completion/coordination of claim inquiries and complaints for the Hospital, Ancillary, and/or Professional network; coordinate Joint Operating Committees (JOCs), claim review and resolution and support of audits when needed.
     
  • Assist participating providers when issues require coordination of various Plan departments (Claims, Care Management, EDI, Grievance and Appeal, Customer Service, Enrollment, Special Investigations, Credentialing, etc.). 
     
  • Provide timely, useful, and accurate responses to provider requests (provider requests for Plan materials; provider questions regarding fees, the Plan's website and IVR; information in the Plan's Provider Manual, and escalated claim inquiries.
     
  • Ensure and coordinate notification and education of various departments within the EH on contract terms and related issues and conditions.
     
  • Coordinate delegated credentialing functions and activities.
     
  • Ensure the accuracy of provider demographic data in the Plan's database: review provider data for assigned Providers; handle provider requests for demographic changes; research provider address discrepancies identified by provider returned mail and potential provider demographic errors identified by other Plan departments or initiatives.
     
  • May recruit available providers to fulfill Network deficiencies.
     
  • Perform outreach projects which may include requests by the Plan's State Sponsored Programs Department for DOH, IPRO and DOI notices, HEDIS medical record retrieval and other projects as needed. 
     
  • Document all outreach activities in compliance with department standards.
     
  • Perform additional duties as directed, assigned, or required.

Qualifications

  • Bachelor's degree in health care - related field, Public Administration, Management, or equivalent.
     
  • 3 - 5+ years of direct provider relations experience  (Required) 
     
  • Knowledge of provider and payor roles, responsibilities and challenges  (Required)
     
  • An understanding of health care financing, access issues, delivery systems, quality controls, and legislation  (Required)
     
  • Strong customer service skills and the ability to maintain an excellent rapport with providers and their staff  (Required)
     
  • Ability to work well with various Plan departments is instrumental in the effectiveness of the position  (Required) 
     
  • Excellent communication skills, written and verbal, to ensure that the appropriate requests are articulated and that problems are accurately represented for resolution  (Required)
     
  • Time management skills and flexibility to work on multiple projects/assignments simultaneously, with ability to change focus in a crisis situation. Willingness to assume diverse duties and challenges  (Required)
     
  • Interpersonal skills to effectively maintain working relationships to get issues resolved or to obtain information through people, and to represent the Plan and the Department in a favorable light  (Required)
     
  • Ability to work independently assignments and maximize opportunities to support  (Required)
     
  • Analytical and problem-solving skills to identify needs in provider relationships, make recommendations as projects develop and follow through to resolution using available resources to achieve a solution  (Required)
     
  • Proficiency in MS Office - Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.  (Required)
Additional Information
  • Requisition ID: 1000003034
  • Hiring Range: $56,160-$99,360

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