Sr. Managed Care Network Manager [Remote]

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Sr. Managed Care Network Manager based in United States.

In this role, you will serve as a key driver of managed care network performance and provider relations strategy, ensuring effective coordination between health plans, provider groups, and internal stakeholders. You will play a central role in implementing managed care agreements, optimizing network operations, and supporting the seamless integration of acquired and affiliated provider groups. The position blends strategic contract management with hands-on operational problem-solving, requiring close collaboration with clinical, administrative, and insurance partners. You will also contribute to strengthening payer relationships, improving reimbursement outcomes, and ensuring compliance across managed care arrangements. Operating in a highly collaborative healthcare environment, you will help shape more efficient, patient-centered network systems while supporting continuous improvement initiatives. This is a highly visible role that combines analytical thinking, negotiation expertise, and cross-functional coordination within a mission-driven organization.

Accountabilities:

• Coordinate and implement managed care plans by working closely with internal teams, provider groups, and external health plan partners to ensure effective execution of network strategies.
• Lead provider group transitions, including acquired and affiliated organizations, ensuring smooth onboarding and alignment with managed care requirements.
• Develop and maintain strong relationships with managed care plans through consistent communication, negotiation, and partnership management.
• Negotiate contract terms, amendments, and agreements with payers to achieve favorable reimbursement and operational outcomes.
• Monitor managed care plan performance to ensure compliance, efficiency, and alignment with organizational objectives.
• Support resolution of escalated issues, claims payment challenges, and operational concerns related to managed care contracts.
• Coordinate provider credentialing processes for affiliated and acquired groups within managed care networks.
• Facilitate training and education for provider leadership on managed care policies, procedures, and requirements.
• Collaborate with stakeholders to address clinical, operational, and claims-related issues and ensure timely resolution.
• Contribute to continuous improvement initiatives aimed at enhancing managed care operations and network effectiveness.
• Review and evaluate managed care proposals to ensure alignment with organizational goals and financial targets.
• Perform additional duties as needed to support managed care network performance and organizational success.

Requirements

• Bachelor’s degree in Healthcare, Business, or a related field (Master’s preferred).
• 7+ years of experience in healthcare, insurance, provider relations, or managed care environments.
• Strong experience in provider network management, contract negotiation, and contract administration.
• Solid understanding of medical terminology, CPT coding, and reimbursement methodologies.
• Proven ability to negotiate and manage complex payer contracts and amendments.
• Experience working with provider groups, health plans, and healthcare delivery systems.
• Strong analytical, organizational, and problem-solving skills with the ability to manage multiple priorities.
• Excellent verbal and written communication skills with the ability to engage clinical, administrative, and executive stakeholders.
• Proficiency in Microsoft Office Suite, including Excel and Access, with strong overall computer literacy.
• Ability to work independently in a remote environment while managing deadlines and variable schedules.
• Strong interpersonal skills with the ability to build trust and collaborate across diverse healthcare stakeholders.
• Experience in training, education, or change management within provider or payer environments is a plus.

Benefits

• Competitive salary range: $66,170.74 – $123,073.07 annually (based on experience and qualifications).
• Comprehensive medical, dental, and vision insurance coverage.
• Life insurance and disability coverage provided.
• Paid time off starting from day one.
• 403(b) retirement savings plan.
• 100% paid parental leave (4 weeks).
• Career development and internal growth opportunities.
• Mental health resources and employee wellness support programs.
• Pet benefits and additional lifestyle perks.
• Flexible work arrangements with fully remote options.
• Inclusive, mission-driven environment focused on whole-person well-being.

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.