Manager of Contracting in san bernardino, California at LSMA Management Inc

JOB SUMMARY

The Manager of Contracting is responsible for the day-to-day management, negotiation, implementation, and administration of payer, provider, and vendor contracts for LSMA Management, Inc., LaSalle Health Plan, and Maren Medical Group. Under the direction of the Vice President of Contracting, the Manager oversees contracting activities that support organizational objectives, provider network development, reimbursement optimization, and regulatory compliance.

The Manager develops and maintains productive relationships with health plans, physicians, hospitals, ancillary providers, and strategic vendors while coordinating contract negotiations, implementation, amendments, renewals, and ongoing contract performance. This position collaborates closely with Finance, Medical Management, Provider Relations, Credentialing, Compliance, Legal Counsel, and Operations to ensure contractual obligations are effectively implemented and monitored.

The Manager is responsible for maintaining contract documentation, monitoring reimbursement performance, supporting value-based care initiatives, ensuring compliance with applicable federal and California healthcare regulations, and supervising the daily operations of the Contracting department.

MINIMUM & PREFERRED QUALIFICATIONS

Education/Training

Minimum: Bachelor's degree in Healthcare Administration, Business Administration, Finance, Public Health, or related field required.

Preferred: Master's degree (MBA, MHA, MPH, JD, or related discipline).

Experience

Minimum: At least five to seven years of progressively responsible healthcare contracting experience. Minimum three (3) years of supervisory or project leadership experience. Experience negotiating managed care payer and provider contracts. Experience within an MSO, IPA, health plan, medical group, ACO, or integrated delivery system. Experience with Commercial, Medicare Advantage, and Medi-Cal reimbursement models.

Preferred: California managed care contracting experience. Experience with delegated services agreements. Experience supporting value-based payment programs.

Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.

Skills, Knowledge & Abilities

· Thorough knowledge of healthcare contracting principles.

· Knowledge of managed care reimbursement methodologies.

· Understanding of provider network development.

· Knowledge of CMS, DHCS, DMHC, and California managed care regulations.

· Strong contract negotiation skills.

· Financial analysis and reimbursement modeling abilities.

· Excellent written and verbal communication skills.

· Ability to interpret legal agreements.

· Strong organizational and project management skills.

· Ability to supervise multiple projects simultaneously.

· Proficiency in Microsoft Office and contract management software.

· Strong interpersonal and relationship-building skills.

PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS

The physical demands described here are represented by those that must be met by an employee to successfully perform the essential functions of this job. This position performs work in a professional office environment and requires prolonged computer use, frequent communication in person and through virtual platforms, and occasional travel to provider offices, health plans, and business meetings. The position requires the ability to lift and carry up to 20 pounds on an occasional basis.

PAY RANGE

$110,000.00 - $130,000.00 / annually