What are the responsibilities and job description for the Provider Network & Contract Manager position at Senior Care Partners PACE?
- Purpose
- Professional Development
- Paid Holidays
- PTO and SIck Time
- Internal opportunities for growth
- Team Support
- Competitive Pay
- Medical, Dental, Vision Insurance
- Life insurance
- 403(b) Retirement Savings
- Employee Assistance
- And MORE!
Meaningful work with a purpose
Professional development opportunities
Paid holidays generous PTO
Flexible, team-oriented culture
Competitive pay & great benefits: Medical, Dental, Vision, Life Insurance, Telemedicine
403(b) retirement savings plan
Primary Purpose
Responsible for managing provider network operations, including provider contracting, credentialing, compliance, and relationship management. Ensures a high-quality, compliant provider network that supports participant care and aligns with Federal, State, and organizational requirements.
Key Responsibilities
- Develop, negotiate, and manage provider contracts and network relationships.
- Ensure provider network adequacy, credentialing compliance, and adherence to CMS and MDHHS requirements.
- Monitor provider performance, conduct audits, and manage corrective action plans.
- Educate and onboard providers regarding organizational policies, procedures, and the PACE model of care.
- Maintain provider network data, contract documentation, and related policies and procedures.
- Collaborate with internal departments and external partners to support service delivery, quality outcomes, and value-based care initiatives.
- Resolve provider and contract-related issues while maintaining high customer service standards.
- Participate in quality improvement, compliance reviews, and regulatory audits.
Leadership Responsibilities
Provides functional leadership for Provider Network and Contract operations. Serves as the primary coordinator for provider contracting, compliance, and credentialing activities while working closely with the Contract Coordinator and cross-functional teams.
- Bachelor’s degree in business administration, Healthcare Administration, or other applicable experience degree required
- 3 to 5 years of contracting / insurance / healthcare experience
- Strong working knowledge of Medicare and Medicaid billing requirements
- Knowledge of PACE and Medicare Advantage Plans preferred
- Must be fully vaccinated or willing to become vaccinated against:
Influenza, MMR, Varicella, Tdap/Td, COVID-19, and Hepatitis B - Must meet CMS competency standards prior to working independently
- Comfortable working in varied home environments and all weather conditions
Join Us!
If you’re ready to do meaningful work in a place where you feel you truly belong, where partnership drives every interaction, and where excellence and ownership guide how we care for our participants and one another, we invite you to apply. Senior Care Partners PACE is proud to be an Equal Employment Opportunity employer.