Supervisor, Provider Contracts

Posted Tuesday, May 19, 2026 at 10:00 AM General Description This role functions as a hands‑on manager and primary escalation point for complex negotiations, regulatory interpretation, and financial risk assessment, while actively supporting day‑to‑day contracting work. In addition to directly contributing to negotiations and issue resolution, the role drives standardization, performance management, and continuous operational improvement within the contracting function. It requires a leader with deep subject‑matter expertise, sound judgment, and the ability to balance strategic direction with practical execution. Qualifications The following represents the typical way to achieve the necessary skills, knowledge, and ability to qualify for this position: Education and Experience Bachelor’s degree in healthcare administration, public policy, business, law, or a related field required; three (3) years of progressive provider contracting experience in a managed care or health plan environment, including supervisory experience. Master’s degree (MBA, MPH, MHA) highly desirable. Skills Advanced contract negotiation, drafting, redlining, and financial impact analysis across complex provider arrangements. Advanced ability to evaluate reimbursement methodologies, rate strategies, and total cost of care impacts. Intermediate leadership skills in supervising, coaching, and developing experienced contract management professionals. Intermediate skills in interpreting and operationalizing complex regulatory requirements from DHCS, CMS, and DMHC. Intermediate proficiency with contract management systems, financial models, and Microsoft Office applications (Excel, Word, Outlook, Teams). Knowledge Extensive knowledge of Medi‑Cal and Medicare managed care regulations, provider billing practices, and payment systems. Extensive knowledge of reimbursement methodologies, provider incentive structures, and audit readiness requirements. Working knowledge of provider performance measurement, including the use of claims, utilization, and financial data to evaluate contract value and network performance. Working knowledge of IT configuration workflows applied to claims, utilization, and financial data for assessing contract value, network performance, and audit readiness. Abilities Demonstrated ability to independently lead complex negotiations and interpret regulatory and financial risks. Demonstrated ability to use claims data to project rate increases, assess cost impact, and support decision‑making. Ability to translate strategic objectives into team priorities and performance standards while contributing to strategic initiatives and improvement of contracting operations. Ability to communicate and problem‑solve effectively with internal and external stakeholders. Licensure/Certifications Not applicable. Driving Not applicable. Duties & Responsibilities Essential Functions Leading People Develop, manage, and lead a team of self‑accountable professionals by modeling real, personal accountability and instilling a culture of psychological safety and accountability. Support direct reports in holding themselves accountable to high performance standards and professional conduct in a clear, helpful, straightforward way. Conduct one‑on‑one conversations with direct report(s), focused on performance, development, and career growth. Ensure compliance with labor laws/regulations, support the implementation of organizational policies and procedures, and foster a positive and inclusive culture. Support the development, implementation, and monitoring of the department budget, to ensure efficient resource allocation and compliance with policies. Delivering Results Provide strategic oversight of provider contract negotiations, ensuring alignment with financial, regulatory, and network objectives. Review and approve high‑impact contracts, amendments, and rate changes, ensuring appropriate risk mitigation and documentation. Oversee analysis of claims, utilization, and financial data to support reimbursement strategies and executive decision‑making. Execute, implement, and maintain accurate provider agreements timely. Leading Change Drive continuous improvement of contracting workflows, standards, and templates. Lead initiatives to enhance contract management systems, data integrity, and reporting. Translate regulatory changes into actionable guidance, tools, and processes for the team. Lead change management efforts to ensure adoption of new processes, technologies, and performance expectations. Building Coalitions Serve as a primary contracting liaison across organizational stakeholders. Represent the contracting function in cross‑functional forums, audits, and strategic initiatives. Partner with internal stakeholders to resolve complex provider disputes, escalations, and operational challenges. Build and maintain effective relationships with provider organizations to support long‑term network stability and collaboration. Secondary Functions Adhere to work performance norms and attendance expectations. Perform other duties as assigned. The Health Plan of San Mateo (HPSM) is an equal opportunity employer and is committed to providing equal employment opportunities to all applicants and employees without regard to race, color, religion, creed, political affiliation, sex, gender, gender identity or expression, pregnancy, childbirth and related medical conditions, marital status, registered domestic partner status, sexual orientation, age, ancestry, national origin, citizenship status, veteran or military status, disability, medical condition, genetic information, or any other characteristic protected by applicable federal, state, or local law. This policy applies to all aspects of employment, including recruitment, hiring, selection, placement, promotion, transfer, demotion, compensation, benefits, training, discipline, and termination. HPSM is committed to providing reasonable accommodations to qualified individuals with disabilities and to applicants and employees with sincerely held religious beliefs or practices, in accordance with applicable law. If you require an accommodation during the application or interview process, or in order to perform the essential functions of a position, please contact the HPSM recruiter to request assistance. #J-18808-Ljbffr Health Plan of San Mateo