Responsible for leading complex, high-value provider contracting initiatives across Medicaid, Medicare Advantage, and Commercial lines of business. Participates in the development of and executes ...
Responsible for leading complex, high-value provider contracting initiatives across Medicaid, Medicare Advantage, and Commercial lines of business. Participates in the development of and executes ...
SHP Provider Contracting Consult-Senior
Corvallis, OR · On-site
$42.11 - $63.16/hr
Responsible for leading complex, high-value provider contracting initiatives across Medicaid, Medicare Advantage, and Commercial lines of business. Participates in the development of and executes ...
SHP Provider Contracting Consult-Senior
Corvallis, OR · On-site
$42.11 - $63.16/hr
Responsible for leading complex, high-value provider contracting initiatives across Medicaid, Medicare Advantage, and Commercial lines of business. Participates in the development of and executes ...
Responsible for leading complex, high-value provider contracting initiatives across Medicaid, Medicare Advantage, and Commercial lines of business. Participates in the development of and executes ...
Responsible for leading complex, high-value provider contracting initiatives across Medicaid, Medicare Advantage, and Commercial lines of business. Participates in the development of and executes ...
SVP, National Provider Contracting & Network Development
Oakland, CA · On-site
$250 - $350/hr
The Senior Vice President, Health Plan and Hospital Provider Contracting and Network Development, is directly accountable for provider contracting across Kaiser Foundation Health Plan and Hospitals ...
SVP, National Provider Contracting & Network Development
Oakland, CA · On-site
$250 - $350/hr
The Senior Vice President, Health Plan and Hospital Provider Contracting and Network Development, is directly accountable for provider contracting across Kaiser Foundation Health Plan and Hospitals ...
$250 - $350/hr
The Senior Vice President, Health Plan and Hospital Provider Contracting and Network Development, is directly accountable for provider contracting across Kaiser Foundation Health Plan and Hospitals ...
$250 - $350/hr
The Senior Vice President, Health Plan and Hospital Provider Contracting and Network Development, is directly accountable for provider contracting across Kaiser Foundation Health Plan and Hospitals ...
Senior Provider Contracting & Compensation Analyst
Los Gatos, CA · On-site
$130K - $155K/yr
El Camino Health Medical Network is currently seeking a skilled Senior Provider Contracting & Compensation Analyst to join our growing healthcare team! Pay: $130,000-$155,000 annualized Location: Los ...
Senior Provider Contracting & Compensation Analyst
Los Gatos, CA · On-site
$130K - $155K/yr
El Camino Health Medical Network is currently seeking a skilled Senior Provider Contracting & Compensation Analyst to join our growing healthcare team! Pay: $130,000-$155,000 annualized Location: Los ...
You are responsible for leading and managing the contracting function in Provider Services and overseeing the work of the employees in the CFR department as well as outside contracted vendors. These ...
You are responsible for leading and managing the contracting function in Provider Services and overseeing the work of the employees in the CFR department as well as outside contracted vendors. These ...
You are responsible for leading and managing the contracting function in Provider Services and overseeing the work of the employees in the CFR department as well as outside contracted vendors. These ...
You are responsible for leading and managing the contracting function in Provider Services and overseeing the work of the employees in the CFR department as well as outside contracted vendors. These ...
Senior Provider Contracting & Compensation Analyst
Los Gatos, CA · On-site
$130K - $155K/yr
El Camino Health Medical Network is currently seeking a skilled Senior Provider Contracting & Compensation Analyst to join our growing healthcare team! Pay: $130,000-$155,000 annualized Location: Los ...
Senior Provider Contracting & Compensation Analyst
Los Gatos, CA · On-site
$130K - $155K/yr
El Camino Health Medical Network is currently seeking a skilled Senior Provider Contracting & Compensation Analyst to join our growing healthcare team! Pay: $130,000-$155,000 annualized Location: Los ...
You are responsible for leading and managing the contracting function in Provider Services and overseeing the work of the employees in the CFR department as well as outside contracted vendors. These ...
You are responsible for leading and managing the contracting function in Provider Services and overseeing the work of the employees in the CFR department as well as outside contracted vendors. These ...
You are responsible for leading and managing the contracting function in Provider Services and overseeing the work of the employees in the CFR department as well as outside contracted vendors. These ...
You are responsible for leading and managing the contracting function in Provider Services and overseeing the work of the employees in the CFR department as well as outside contracted vendors. These ...
Sr. Healthcare Provider Contracting Analyst
Santa Barbara, CA · On-site +1
$120K - $181K/yr
Job Summary The Sr. Healthcare Provider Contracting Analyst independently performs complex financial modeling, reimbursement rate development, and provider contract change analysis for Medicaid ...
Sr. Healthcare Provider Contracting Analyst
Santa Barbara, CA · On-site +1
$120K - $181K/yr
Job Summary The Sr. Healthcare Provider Contracting Analyst independently performs complex financial modeling, reimbursement rate development, and provider contract change analysis for Medicaid ...
DIRECTOR, CONTRACTING & PROVIDER RELATIONS - UNM HOSPITAL - ALBUQUERQUE, NM
Albuquerque, NM · On-site
$120 - $180/hr
The Director will oversee provider contracting, network development, provider onboarding, provider education, issue resolution and provider performance initiatives. The position collaborates closely ...
DIRECTOR, CONTRACTING & PROVIDER RELATIONS - UNM HOSPITAL - ALBUQUERQUE, NM
Albuquerque, NM · On-site
$120 - $180/hr
The Director will oversee provider contracting, network development, provider onboarding, provider education, issue resolution and provider performance initiatives. The position collaborates closely ...
As Provider Contracting Advisor , you'll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you'll assist in developing our ...
As Provider Contracting Advisor , you'll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you'll assist in developing our ...
Provider Contracting Advisor - Hospital & Physician Negotiations - Hybrid - Pittsburgh, PA
Erie, PA · On-site +1
As Provider Contracting Advisor , you'll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you'll assist in developing our ...
Provider Contracting Advisor - Hospital & Physician Negotiations - Hybrid - Pittsburgh, PA
Erie, PA · On-site +1
As Provider Contracting Advisor , you'll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you'll assist in developing our ...
Provider Contracting Advisor - Hospital & Physician Negotiations - Hybrid - Pittsburgh, PA
Pittsburgh, PA · On-site +1
As Provider Contracting Advisor , you'll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you'll assist in developing our ...
Provider Contracting Advisor - Hospital & Physician Negotiations - Hybrid - Pittsburgh, PA
Pittsburgh, PA · On-site +1
As Provider Contracting Advisor , you'll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you'll assist in developing our ...
Sr. Healthcare Provider Contracting Analyst
Santa Barbara, CA · On-site +1
$120K - $181K/yr
Job Summary The Sr. Healthcare Provider Contracting Analyst independently performs complex financial modeling, reimbursement rate development, and provider contract change analysis for Medicaid ...
Sr. Healthcare Provider Contracting Analyst
Santa Barbara, CA · On-site +1
$120K - $181K/yr
Job Summary The Sr. Healthcare Provider Contracting Analyst independently performs complex financial modeling, reimbursement rate development, and provider contract change analysis for Medicaid ...
Provider Contracting Advisor - Hospital & Physician Negotiations - Hybrid - Pittsburgh, PA
Clarion, PA · On-site +1
As Provider Contracting Advisor , you'll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you'll assist in developing our ...
Provider Contracting Advisor - Hospital & Physician Negotiations - Hybrid - Pittsburgh, PA
Clarion, PA · On-site +1
As Provider Contracting Advisor , you'll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you'll assist in developing our ...
Provider Contracting Advisor - Hospital & Physician Negotiations - Hybrid - Pittsburgh, PA
Altoona, PA · On-site +1
As Provider Contracting Advisor , you'll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you'll assist in developing our ...
Provider Contracting Advisor - Hospital & Physician Negotiations - Hybrid - Pittsburgh, PA
Altoona, PA · On-site +1
As Provider Contracting Advisor , you'll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you'll assist in developing our ...
Provider Contracting Advisor - Hospital & Physician Negotiations - Hybrid - Pittsburgh, PA
Altoona, PA · On-site +1
As Provider Contracting Advisor , you'll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you'll assist in developing our ...
Provider Contracting Advisor - Hospital & Physician Negotiations - Hybrid - Pittsburgh, PA
Altoona, PA · On-site +1
As Provider Contracting Advisor , you'll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you'll assist in developing our ...
Provider Contracting information
What is provider contracting?
Provider contracting is the process by which healthcare organizations, such as insurance companies or health plans, establish agreements with medical providers, such as hospitals, physicians, and clinics. These contracts outline the terms of service, payment rates, and responsibilities for both parties. The goal is to ensure that patients have access to a network of qualified providers at agreed-upon costs, while providers receive timely and consistent reimbursement for their services.
What are the key skills and qualifications needed to thrive as a provider contracting specialist?
To thrive as a Provider Contracting Specialist, you need strong negotiation skills, analytical abilities, and a background in healthcare administration or business, often supported by a bachelor's degree. Familiarity with contract management software, claims processing systems, and regulatory compliance tools is typically required. Exceptional communication, relationship-building, and attention to detail are vital soft skills for success in this role. These competencies ensure effective contract negotiations, compliance with regulations, and the development of strong provider networks that benefit both patients and organizations.
What are some common challenges faced in a provider contracting role, and how can they be managed effectively?
Professionals in Provider Contracting often encounter challenges such as negotiating mutually beneficial agreements, keeping up with evolving healthcare regulations, and balancing provider expectations with organizational goals. Effective management of these challenges requires strong communication and negotiation skills, as well as staying current on industry trends and compliance requirements. Building collaborative relationships with providers and internal teams, maintaining clear documentation, and leveraging data analytics can help streamline the contracting process and achieve successful outcomes.
What is the difference between Provider Contracting vs Provider Relations Specialist?
| Aspect | Provider Contracting | Provider Relations Specialist |
|---|---|---|
| Primary Focus | Negotiating and managing provider contracts | Building and maintaining provider relationships |
| Responsibilities | Contract negotiations, rate setting, compliance | Provider communication, issue resolution, outreach |
| Required Skills | Negotiation, understanding of contracts, industry regulations | Communication, customer service, relationship management |
| Work Environment | Office-based, healthcare organizations, insurance companies |
Provider Contracting focuses on negotiating and managing provider agreements, ensuring compliance and optimal rates. In contrast, Provider Relations Specialists prioritize maintaining strong provider relationships, addressing concerns, and facilitating communication. Both roles are essential in healthcare administration but serve different functions within the provider network.
More about Provider Contracting jobs
What cities are hiring for Provider Contracting jobs?
Cities with the most Provider Contracting job openings:
What are the most commonly searched types of Provider Contracting jobs?
The most popular types of Provider Contracting jobs are:
What states have the most Provider Contracting jobs?
States with the most job openings for Provider Contracting jobs include:
Full-time
Re-posted 17 days ago
Samaritan Health Services rating
7.5
Based on 65 frontline employees who took The Breakroom Quiz
237th of 891 rated healthcare providers
Job description
- This is a remote position in which we are able to employ in the following states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin
- JOB SUMMARY/PURPOSE
- Responsible for leading complex, high-value provider contracting initiatives across Medicaid, Medicare Advantage, and Commercial lines of business. Participates in the development of and executes multi-year contracting strategies for hospitals, health systems, large physician organizations, and other strategic providers. Serves as a subject matter expert in reimbursement methodologies, value-based payment design, and regulatory compliance. Leads high-stakes negotiations, performs advanced financial modeling, advises executive leadership on network strategy, and mentors contracting staff. Exercises broad discretion within delegated authority and significantly influences organizational cost-of-care, network adequacy, and quality performance outcomes.
- DEPARTMENT DESCRIPTION
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage and Commercial Large Group plans. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
- EXPERIENCE/EDUCATION/QUALIFICATIONS
- Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or a related field, or equivalent related experience required.
- Four (4) years of progressive provider contracting experience in a managed care environment required.
- Experience negotiating complex hospital, health system, and risk-based agreements required.
- Experience across Medicaid, Medicare Advantage, and Commercial product lines required.
- Extensive experience designing and managing value-based payment and alternative payment models required.
- KNOWLEDGE/SKILLS/ABILITIES
- Deep understanding of federal and state regulatory requirements. Expert-level knowledge of healthcare reimbursement methodologies (DRG/IPPS, OPPS, capitation, percent-of-Medicare, bundled payments, risk arrangements).
- Advanced financial modeling and analytical skills (expert-level Excel proficiency required).
- Ability to manage multiple high-priority initiatives simultaneously. Exceptional negotiation, influence, and conflict resolution skills.
- Strong executive presence and ability to communicate complex financial concepts to senior leadership.
- Strategic thinker with strong business and market acumen.
- Proven leadership and mentoring capability.
- PHYSICAL DEMANDS
Rarely
(1 - 10% of the time)Occasionally
(11 - 33% of the time)Frequently
(34 - 66% of the time)Continually
(67 – 100% of the time)CLIMB - STAIRS
LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
LIFT (Knee to chest: 24"-54") 0 – 20 Lbs
LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
CARRY 1-handed, 0 - 20 pounds
BEND FORWARD at waist
KNEEL (on knees)
STAND
WALK – LEVEL SURFACE
ROTATE TRUNK Standing
REACH - Upward
PUSH (0 - 20 pounds force)
PULL (0 - 20 pounds force)
SIT
CARRY 2-handed, 0 - 20 pounds
ROTATE TRUNK Sitting
REACH - Forward
MANUAL DEXTERITY Hands/wrists
FINGER DEXTERITY
PINCH Fingers
GRASP Hand/Fist
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