Provider Contracts Manager

Company Description Texas Children’s Health Plan, founded in 1996, is the nation’s first health maintenance organization (HMO) created specifically for children. The organization provides STAR/Medicaid and Children’s Health Insurance Program (CHIP) coverage to pregnant people, teens, children, and adults in Houston and surrounding areas. More than 375,000 members receive care through a broad network of over 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children’s Health Plan is the largest combined STAR/CHIP Managed Care Organization in the Harris County service area, offering comprehensive, community-focused care. Team members join a mission-driven organization dedicated to improving access to quality health care for families across the region. Role Description The Provider Contracts Manager is a full-time, on-site role based in Houston, TX, responsible for managing and overseeing contracts with providers across the health plan’s network. This role includes negotiating contract terms and reimbursement rates, drafting and reviewing agreements, and ensuring alignment with regulatory requirements and organizational policies. The Provider Contracts Manager monitors contract performance, analyzes utilization and financial data, and collaborates with internal teams to resolve contract-related issues and improve provider relationships. Daily responsibilities also involve responding to provider inquiries, supporting network development initiatives, and maintaining accurate contract records and documentation. The role works closely with legal, finance, provider relations, and network management teams to support sustainable, high-quality care delivery for plan members. Qualifications Experience in provider contracting, payor contracting, or network management within a health plan, hospital, or managed care environment. Strong skills in negotiation, financial analysis, and contract review, with the ability to interpret reimbursement terms and fee schedules. Knowledge of Medicaid, CHIP, and managed care regulations, as well as familiarity with health care delivery systems and provider operations. Proficiency in data analysis and reporting tools (e.g., Excel, database systems) and ability to use data to inform contract decisions. Excellent written and verbal communication skills, with attention to detail and strong organizational abilities. Demonstrated ability to work collaboratively with cross-functional teams and build effective relationships with providers and internal stakeholders. Bachelor’s degree in Business, Health Administration, Finance, or a related field; advanced degree or professional certification in healthcare management is a plus. Prior experience in a managed care organization in Texas or similar market and familiarity with Texas Medicaid/CHIP programs is highly beneficial. #J-18808-Ljbffr