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Contracting Systems Manager - Health Plan

$92.4k - $133.67k

SCAN Health Plan

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do.Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.The JobThe Contracting Systems Manager serves as the contracting subject matter expert responsible for ensuring provider contract intent is accurately translated into system configuration and operational outcomes. Acting as the primary Contracting representative for QNXT, contract management systems, and related enterprise implementations, this role provides oversight of contract-to-configuration alignment, testing validation, discrepancy resolution, and implementation readiness to reduce financial, operational, and provider disruption risk.This position partners closely with Configuration, Claims, IT, Network Management, Provider Operations, Finance, and implementation teams to ensure provider contract requirements are accurately operationalized and sustained throughout the contract lifecycle, including new agreements, renewals, amendments, and system enhancement initiatives.You WillServe as the Contracting subject matter expert for QNXT, contract management system, and other enterprise system implementations.Provide oversight and validation of contract-to-configuration alignment to ensure provider agreements are accurately operationalized.Review complex reimbursement methodologies and contract provisions to identify risks associated with system configuration and claims adjudication.Lead contract-related testing activities including UAT, parallel testing, payment validation, and go-live readiness assessments.Identify, investigate, and escalate discrepancies between contract intent and system outcomes.Partner with Configuration, Claims, IT, Provider Operations, and implementation teams to develop solutions for contract implementation issues.Establish and maintain processes and controls that support ongoing contract-to-system accuracy.Serve as the primary business resource for contract implementation, renewals, amendments, and system enhancement initiatives.Analyze operational and financial impacts of contract implementation decisions and provide recommendations to leadership.Lead special projects and process improvement initiatives supporting enterprise contracting and payment accuracy objectives.We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.Actively support the achievement of SCAN’s Vision and Goals. Other duties as assigned.Experience Required:Bachelor's degree or equivalent experience in Healthcare Administration, Business Administration, Finance, Information Systems, Public Health, or related field5+ years of experience in managed care, provider contracting, network management, claims operations, configuration support, healthcare systems implementation, or related healthcare or health insurance plan operations.Experience interpreting and applying complex provider contract terms, reimbursement methodologies, and payment arrangements.Experience participating in large-scale operational or technology implementations.Experience collaborating across multiple business functions, including Contracting, Claims, Configuration, Operations, Network Management, Finance, and Information Technology.Experience supporting testing, validation, issue resolution, implementation readiness, and production support activities for business-critical systems.Strong analytical experience identifying operational, financial, payment, and implementation risks and developing recommendations for resolution.Microsoft Office (Word, Excel, PowerPoint, Teams, Outlook) at advanced skill level.Experience Preferred:Experience with QNXT or other healthcare claims administration platforms.Experience supporting Contract Lifecycle Management systems or contract repository solutions.Experience with user acceptance testing, parallel testing, payment validation, and production readiness activities.Knowledge of provider configuration, claims adjudication, fee schedules, value-based reimbursement models, delegated risk arrangements, and Medicare Advantage operations.Experience supporting enterprise transformation initiatives, system conversions, or business process redesign efforts.Experience facilitating discussions between technical, operational, and business stakeholders.Experience developing implementation standards, quality controls, workflows, and operational procedures.Project management or process improvement experience preferred.What's in it for you?Base salary range: $92,400 to $133,671 per yearInternal title: Contracts ManagerWork Mode: Mostly RemoteAn annual employee bonus programRobust Wellness ProgramGenerous paid-time-off (PTO)Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holidayExcellent 401(k) Retirement Saving Plan with employer match and contributionRobust employee recognition programTuition reimbursementAn opportunity to become part of a team that makes a difference to our members and our community every day!We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.#LI-MS1#LI-HybridEqual Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)SummaryLocation: Long Beach, CA; Remote, USType: Full time

Vacancy posted 2 days ago
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