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Vendor Contract and Performance Specialist II

$77.27k

L.A. Care Health Plan

Salary Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary 2 Positions Available The Vendor Contract and Performance Specialist II supports the vendor contracting and performance functions by participating in contract negotiations, provider onboarding, and issue resolution activities. This role acts as a liaison between the organization and providers, facilitating communication, supporting value-based care initiatives, and contributing to cross-functional projects. The Specialist applies analytical skills to resolve provider concerns, monitors contractual benchmarks, and prepares reports for leadership. Collaboration with internal teams is essential and reinforces process standards and actions foster a culture of service excellence. Duties Advances L.A. Care's organizational goals by negotiating and executing vendor contracts that align with both our strategic vision and regulatory requirements. Ensures that every agreement strengthens our network and supports compliance. Monitor service level agreements, review vendor key performance indicators, scorecards and efficiency. Escalates complex issues in a timely manner to address issues. Facilitates provider onboarding, orientation, and ongoing education to foster strong relationships and seamless integration. Manage provider issues from intake, basic analysis to resolution. Escalates complex concerns, reinforces enterprise commitment to responsiveness and service excellence. Through application of analytical skills, drive progress monitoring against contractual benchmarks as well as contributions of including preparation of insightful reports for leadership review. Through active participation in collaboration with cross functional helps deliver holistic solutions that propel organizational success. Accountable, responsive, and fosters service excellence within provider engagement and contracting functions, ensuring our organization remains a trusted partner and industry leader. Performs other duties as assigned. Education Required Bachelor's Degree in Business or Related Field In lieu of degree, equivalent education and/or experience may be considered. Experience Required: At least 3 years of experience in managed care contracting, vendor operations, provider relations, health plan operations, or hospital/facility settings. Demonstrated ability to support contract negotiations and ensure regulatory compliance. Experience coordinating cross-functional initiatives and using data to improve outcomes. Preferred: Experience working with Medi-Cal, Medicare Advantage, DHCS, DMHC, CMS, and NCQA, ensuring compliance and alignment with industry standards Skills Required: Proven proficiency in negotiating and managing provider agreements. Strong financial data analysis, knowledge of medical billing/claims, Good written and verbal communication. Ability to leverage a foundational understanding of managed care operations and delegated risk environments to ensure optimal outcomes. Ability to conduct root-cause analysis, support operational improvement initiatives, and make data-driven decisions that enhance organizational performance. Ability to effectively manage key stakeholders. Ability to seamlessly collaborate with cross functional areas to drive results and resolve challenges. Strong organizational skills with the ability to manage multiple projects simultaneously, document key decisions, and follow through on action items with precision and accountability. Solid knowledge and expertise with office productivity tools. Ability to perform robust analysis, deliver impactful presentations, and provide timely updates to stakeholders. This combination of technical acumen, analytical capability, and ability to collaborate. Preferred: Familiarity with capitation, value-based care, provider contracting, and hospital partnerships, supporting the organization’s commitment to innovative and sustainable healthcare delivery. Strong expertise in provider data management, directory standards, and regulatory reporting, with the ability to maintain accurate records and uphold transparency. Ability to lead provider training, craft clear communications, and resolve operational and payment issues positions this role as a trusted resource for both internal teams and external partners. A working knowledge of medical coding frameworks, including ICD-10 and CPT, combined with experience in cross-functional collaboration. Ability to bridge gaps between clinical, operational, and administrative functions. Physical Requirements Light Additional Information Travel to offsite locations for work required. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care Offers a Wide Range Of Benefits Including Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO) #J-18808-Ljbffr L.A. Care Health Plan

Vacancy posted 4 hours ago
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