Provider Contract Manager

Req Number: Req #1895

DUTIES AND RESPONSIBILITIES

Monitor provider network performance and growth. Focus on growth, efficiency and performance of underdeveloped network segments and geographic locations by product line as assigned. Directly manage and provide leadership and mentoring to any direct reports. Maintain accurate and up-to-date provider data in the organization’s system. Assist with the enforcement of departmental quality assurance processes and procedures. Conduct regular reviews and audits of the provider network to ensure accurate data. Conduct and coordinate provider recruitment efforts and related activities, including: Utilize proprietary company information/programs as well as approved non-company systems/programs to identify provider prospects. Recruit and contract with providers. Foster and maintain productive professional relationships with Paradigm providers. Communicate with and provide timely responses to provider inquiries in a manner that demonstrates the Paradigm way. Maintain a thorough understanding of Paradigm’s service offerings and pricing thresholds. Participate in the development of marketing and outreach materials in collaboration with departmental instruction/needs. Document outreach efforts, review results, and modify approach as needed to achieve departmental recruitment objectives in the appropriate contact management system. Support ongoing process improvement activities related to provider recruitment and onboarding. Prepare written reports, correspondence, presentations, orientation materials, and other documentation. Perform research and analysis related to provider network requirements and identify opportunities for network expansion, including: Conduct market research to identify gaps in the provider network, opportunities for network expansion, and trends. Maintain knowledge of Paradigm providers through direct dialogue. Research competitors and utilize available data to monitor hospital and health system networks, including service offerings and rates. Facilitate the contracting process with providers in collaboration with the SVP of Network Development. Perform additional duties as identified and directed by management. Lead adoption of AI‑enabled tools within the team, ensuring effective integration into workflows, coaching employees on usage, monitoring impact on productivity and quality, and identifying opportunities for process improvement. Demonstrate a customer‑first mindset by reinforcing expectations of all employees as drivers of customer excellence, actively fostering engagement, clarity, accountability, and support. Responsible for complying with Paradigm Information Security requirements and policies, safeguarding Paradigm or related passwords, and notifying Paradigm of any Information Security incidents per policy SEC 10-12 Information Security Incident Management.

SUPERVISORY RESPONSIBILITIES

Mentor, train, and supervise team members directly and indirectly, review their work and provide effective constructive feedback to achieve their best performance and goal attainment. Set the tone for a strong Enterprise culture and high employee engagement. Ensure all team members understand, are trained in, and comply with Paradigm’s security requirements and policies. Ensure all team members have the minimum level of IT system access required to effectively complete their Paradigm responsibilities.

QUALIFICATION REQUIREMENTS

Minimum of 7-10 years of contracting experience in the healthcare industry, specific to provider contracting of physicians, surgical facilities, and ancillary services. Minimum of 4-5 years of supervisory experience managing a team performing physician, surgical facility, and ancillary services contracting. Knowledgeable in interpreting and assessing CPT, HCP, DRG, and revenue codes. Experience with Medicare fee schedules, Work Comp fee schedules, UCR and billed charge reimbursement methodologies. College degree preferred; high school diploma or equivalent acceptable with commensurate experience. Exceptional communication and telephone skills required, as well as a great deal of patience, understanding and tact. Possessing a high level of self‑confidence and persistence; maintaining an assertive approach in dealing with providers. Excellent organizational skills and ability to multi‑task effectively. Ability to prioritize a heavy workload independently with minimal supervision. Proficient computer and internet skills; familiarity with Microsoft applications required. Will develop in‑depth knowledge of department and company internal workflows, including but not limited to individual jurisdictional statutes, procedures, and negotiating protocols. Inside sales experience a plus. Bilingual (English/Spanish) a plus. Workers’ Compensation knowledge required. Group Health knowledge required.

BENEFITS

Health and Wellness: We provide PPO, HDHP, and HMO health insurance options with Cigna and Kaiser (CA employees only). Financial Incentives: Competitive salaries, 401(k) matching contributions, employer‑paid life and disability insurance, flexible spending and commuter accounts, and employer‑matched HSA contributions. Vacation: Paid time off and personal holiday programs give flexibility for personal life. Volunteer Time: Full and part‑time employees receive one paid day per calendar year to give back to communities. Learning and Development: The LEAP program supports employee learning and growth.

EEO AND DISABILITY COMPLIANCE

Paradigm believes that fostering a diverse and inclusive workplace is central to our mission. We comply with federal and state disability laws and provide reasonable accommodations for applicants and employees with disabilities. If an accommodation is needed, please contact Leave Management at View email address on click.appcast.io. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, or basis of disability. As a contractor with the State of Wisconsin, Paradigm complies with Wisconsin Contract Compliance Law. Poster available. #J-18808-Ljbffr Paradigm