Provider Contracting Professional Jobs

Become a part of our caring community The Provider Contracting Professional supports the West Region in the negotiation, analysis, and maintenance of physician and other provider agreements for an organization delivering healthcare to the senior population. You will assist with contract management activities, provides analytical support, and ensure accurate documentation within established processes and guidelines. You will report to a Director, Provider Contracting. Job Responsibilities: Support the contracting team in drafting, reviewing, and processing provider contracts and amendments Collaborate with market engagement, leadership, and legal teams to facilitate contract execution and resolve basic contract term revisions Assist in communicating contract terms, payment structures, and reimbursement rates to IPA and ACO provider groups under the guidance of senior staff Conduct initial financial analyses of contracts and terms; prepare summaries for senior review Maintain contract files and documentation within the organization's tracking system, ensuring accuracy and compliance Assist in identifying and reaching out to potential providers for network development based on current needs and network composition Prepare reports and updates for contracting initiatives as requested Manage assigned priorities and deadlines, escalating complex issues to senior team members Use your skills to make an impact Required Qualifications 2+ years' experience in provider contracting, network management, or a related healthcare field Knowledge of managed care or value-based contracting Understand contract terms and basic financial impact Preferred Qualifications Experience supporting ACO or IPA provider

Provider Contracting Professional (Behavioral Health/Medicaid) — 3 Locations. Apply via Workday.

Senior Provider Contracting Professional - Behavioral Health/Medicaid — Remote Nationwide. Apply via Workday.

Become a part of our caring community The Dental Recontracting Professional initiates, negotiates, and executes dental provider contracts and agreements for an organization that provides dental insurance. The Provider Contracting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. This is a VSP role - work specific hours to meet business needs on a limited term basis. The project is expected to go through mid-2027. The Dental Recontracting Professional - VSP will recontract Humana contracted dentists to our new agreement and as needed will communicates contract terms, payment structures, and reimbursement rates to providers. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures and work special projects as needed. This role is Variable Staffing Pool (VSP), Variable Staffing Pool Humana associates work specific hours to meet business needs on a limited term basis. The project is expected to go through mid-2027. This role is also eligible for limited benefits. Use your skills to make an impact Required Qualifications 2 - 5 years of experience negotiating managed care contracts with physician, hospital and/or other provider contracts and/or working with insurance in a dental office Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures a

Become a part of our caring community The Senior Quality Improvement Professional leads efforts to improve clinical quality and provider performance for the Humana Healthy Horizons in South Carolina Medicaid Plan. You will develop and implement cross-functional quality improvement initiatives, evaluate business processes and performance outcomes, and drive sustainable, measurable improvements. Reporting to the Quality Improvement Director, you will collaborate with internal and external stakeholders to advance a provider-focused culture of quality and performance excellence. You will manage complex projects and analyze diverse data sources to identify opportunities, inform strategy, and support organizational objectives. The Senior Quality Improvement Professional leverages data to lead quality improvement initiatives, monitor performance metrics, and support provider performance enhancement. This role collaborates with provider-facing teams to implement targeted interventions, develop educational resources, and drive achievement of quality and member experience goals. The position leads and participates in multidisciplinary committees, provides strategic clinical guidance on quality initiatives, and influences business decisions through data-driven insights. Operating with a high degree of independence, the Senior Quality Improvement Professional manages complex projects, exercises sound judgment, and recommends solutions to advance organizational objectives. Essential Role Responsibilities The Senior Quality Improvement Professional is responsible for improving clinical quality and performance outcomes among South Carolina network providers. Key responsibilities include: Partner with Provider Engagement, Network, and Contracting teams to implement clinical quality improvement strategies including education, training and performanc

Become a part of our caring community Are you ready for a great job? The Value-Based Programs Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Value-Based Programs Analyst work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action The Value-Based Programs Analyst understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas to include, but not limited to: the Value-Based organization, Enrollment, Product Development, Market Finance, Corporate Finance, Actuarial, Network Contracting, and National Contracting. Analyzes provider financial patterns and trends utilizing excel and/or SQL Updates, maintains, and reviews fee scheduling and pricing structures Thoroughly reviews provider contracts and ensure rates are priced and applied accurately Identifies process recommendations and ensures compliance with government regulations Collaborates and communicates with internal partners of all professional levels within various departments The ideal applicant will have the following skills: Problem Solving Provider Management Relationship management Consumer Experiences Confidentiality Data Analysis Detail-Oriented Written Communication In addition to being a great place to work, Humana also offers industry-leading benefits for all employees, starting your FIRST day of employment. Benefits include: Medical Benefits Dental Benefits Vision Benefits Health Savings Accounts Flex Spending Accounts Life Insurance 401(k) PTO including

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. This is a full-time, remote position supporting clients 13&#43; in Washington state and/or California. Qualified candidate must be a Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LICSW), Licensed Professional Clinical Counselor (LPCC), Licensed Mental Health Counselor (LMHC), or Licensed Marriage and Family Therapist (LMFT)​. If hired for the position, must be willing and able to obtain additional state licensure. Join the Minute Clinic team, an industry-leading company for a refreshing change in a stable, consistent, and professional environment. We empower our therapists to practice at the top of their license with the support of our clinical care team, while reaching patients within their communities. What our Mental Health Therapists find at Minute Clinic: - Autonomy to build and grow the Minute Clinic practice without the burden payor contracting, credentialing, and billing. - Opportunities to provide psychosocial support and education needed to address the mental wellbeing of individuals, couples/families ages 13&#43;. - Evidence-based care and access to assessment and treatment planning tools to elevate and support the continuity of care for patients. - Career growth and professional development within the organization. - In-depth training, development, and support. <

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. This is a full-time remote position. Qualified candidates must be a Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Mental Health Counselor (LMHC), or Licensed Marriage Family Therapist (LMFT) in Georgia. Join the MinuteClinic team, an industry-leading company for a refreshing change in a stable, consistent, and professional environment. We empower our therapists to practice at the top of their license with the support of our clinical care team, while reaching patients within their communities. What our Mental Health Therapists find at MinuteClinic: - Autonomy to build and grow the MinuteClinic practice without the burden payor contracting, credentialing, and billing. - Opportunities to provide psychosocial support and education needed to address the mental wellbeing of individuals, couples/families ages 13&#43;. - Evidence-based care and access to assessment and treatment planning tools to elevate and support the continuity of care for patients. - Career growth and professional development within the organization. - In-depth training, development, and support. Required Qualifications - Current, active, and unencumbered state license as a Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Mental Health Counselor (LMHC), or Licensed Mar

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. This is a 40 hour/week, fully remote position supporting patients 13 years and older. Ideal candidate must be a Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), or Licensed Marriage and Family Therapist (LMFT) in Virginia, Maryland, or Washington, D.C. . Must also be willing to obtain additional state licensure. Join the Minute Clinic team, an industry-leading company for a refreshing change in a stable, consistent, and professional environment. We empower our therapists to practice at the top of their license with the support of our clinical care team, while reaching patients within their communities. What our Licensed Clinical Therapists find at Minute Clinic: - Autonomy to build and grow the Minute Clinic practice without the burden payor contracting, credentialing, and billing. - Opportunities to provide psychosocial support and education needed to address the mental wellbeing of individuals, couples/families ages 13&#43;. <

MongoDB is transforming the $138B+ data management software market by empowering developers to build the next generation of applications. As the leading modern data platform—and the first database company to IPO in over 20 years—we're at the forefront of innovation. We are seeking a driven, experienced commercial attorney to lead and scale our U.S. Public Sector and government contracting business. Operating in a fast-paced, high-growth environment, you will serve as the primary legal partner for our public sector sales ecosystem, managing complex transactions and ensuring strict regulatory compliance. This role can be based out of our US offices or remotely in the United States. Core Responsibilities & Requirements End-to-End Deal Execution: Draft, structure, and negotiate high-value public sector and commercial transactions, including SaaS, cloud licensing, professional services, and subcontracting agreements Public Sector Compliance: Provide expert guidance on U.S. and international government procurement laws, including FAR/DFARS frameworks, GSA schedules, and FedRamp requirements, and support ongoing development and refinement of public sector compliance program Strategic Sales Advisory: Advise cross-functional teams throughout the public sector sales lifecycle, from initial RFP evaluations and proposal risk assessments to handling audits or disputes Operational Scalability: Build, refine, and maintain legal playbooks, contract templates, and training modules to streamline negotiations and empower sales teams Regulatory Monitoring: Stay ahead of evolving technology laws, government contracting regulations, and government and defense related export controls to provide proactive, actionable risk mitigation strategies Cross-Functional Collaboration: Work cross-functionally to launch new programs to support growth of commercial and public sector businesses Requirements: 8+ years of US public sector transactions experience, preferably at a law firm a

Who Are We? Postman is the world’s leading API platform, used by more than 45 million+ developers and 500,000 organizations, including 98% of the Fortune 500. Postman is helping developers and professionals across the globe build the API-first world by simplifying each step of the API lifecycle and streamlining collaboration—enabling users to create better APIs, faster. The company is headquartered in San Francisco and has offices in Boston, New York, Austin, Tokyo, London, and Bangalore - where Postman was founded. Postman is privately held, with funding from Battery Ventures, BOND, Coatue, CRV, Insight Partners, and Nexus Venture Partners. Learn more at postman.com or connect with Postman on X via @getpostman. P.S: We highly recommend reading The "API-First World" graphic novel to understand the bigger picture and our vision at Postman. The Opportunity Postman's partner ecosystem is a critical growth lever for the business, connecting the platform to the tools, cloud providers, and technology companies that developers rely on every day. As Commercial Counsel, you will own the legal work that makes these partnerships possible, while also supporting the broader commercial contracting engine that serves Postman's enterprise and mid-market customers. Reporting to the Managing Counsel, Commercial, you will be a trusted advisor to Postman's Partner, Sales, Deal Operations, and Finance teams. You will draft, negotiate, and close the agreements that define how Postman collaborates with strategic partners, channel resellers, system integrators, and marketplace providers. You will also support the full range of commercial transactions, including enterprise subscription agreements and order forms. This role sits at the intersection of legal, product, and business strategy, and the right person will thrive in that position. What You'll Do Commercial Contracting Serve as a primary legal resource for Postman's commercial transactions across the customer lifecycle. Draft, review

POSITION SUMMARY: A Phlebotomist serves patients by identifying the best method for retrieving blood; preparing specimens for laboratory testing; and performing screening procedures. The Phlebotomist will also act as an operations manager for the designated patient service center (PSC) and oversee Natera’s phlebotomy program at the specified location. Depending upon growth opportunities, this role may also require oversight of other phlebotomists as needed to support patient volume growth. *** IF YOUR STATE REQUIRES A PHLEBOTOMY LICENSE, IT MUST BE SENT IN WITH YOUR RESUME WITH YOUR APPLICATION *** PRIMARY RESPONSIBILITIES: Verifies test requisitions by comparing information with orders and requisition documentation; brings discrepancies to the attention of Natera product management leadership. Verifies patient by reading patient identification. Obtains blood specimens by performing venipunctures and finger sticks. Maintains specimen integrity by using aseptic technique, following Natera[KC1] procedures; observes isolation procedures. Tracks collected specimens by initialing, dating, and noting times of collection; maintaining daily tallies of collections performed[MB2] in Natera provided system. Maintains quality results by following Natera procedures and testing schedule; recording results in the quality-control log; identifying and reporting needed changes reporting KPIs to product management leadership on biweekly basis. Maintains safe, secure, and healthy work environment by following standards and procedures; complies with legal regulations. Resolves unusual test orders by contacting the physician, pathologist, nursing station, or reference laboratory; referring unresolved orders back to the originator for further clarification; notifying internal Natera team [MB3] of unresolved orders. Updates job knowledge by participating in educational opportunities; reading professional publications; main

At Snowflake, we are powering the era of the agentic enterprise. To usher in this new era, we seek AI-native thinkers across every function who are energized by the opportunity to reinvent how they work. You don’t just use tools; you possess an innate curiosity, treating AI as a high-trust collaborator that is core to how you solve problems and accelerate your impact. We look for low-ego individuals who thrive in dynamic and fast-moving environments and move with an experimental mindset — who rapidly test emerging capabilities to discover simpler, more powerful ways to deliver results. At Snowflake, your role isn't just to execute a function, but to help redefine the future of how work gets done. Snowflake Services Delivery is the implementation and strategy experts for the Snowflake platform. We engage with customers at all phases of the customer journey to optimise, accelerate, and achieve business outcomes. Our teams of Solutions Architects demonstrate technical leadership everyday by writing code, constructing solution architectures and guiding customers through decision paths to achieve impactful outcomes and thoughtfully use AI to augment their business. We advise everyone from developers through senior executives on how best to utilise Snowflake for their data and AI tool suite to make their business successful. Our Solution Architects are comfortable with change and live on the cutting edge of data and AI. AS A SNOWFLAKE SOLUTIONS ARCHITECT YOU WILL : Customer Engagement & Advisory Directly engage with customers individually or as part of a technical delivery team as a trusted advisor for thought leadership and solution approaches Extract business requirements from customers and translate them into a well-architected recommendation Develop and provide forward-looking guidance and future-state roadmaps Leverage known best practices and solutions to reduce risk to customer implementations Collaborate with Snowflake “Go to Market” teams and product teams to

Executive Director, Medicaid Provider Relations & Contracting - Northeast — 5 Locations. Apply via Workday.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary: This is an individual contributor role. The Senior Manager negotiates, executes, conducts high level review and analysis, dispute resolution and/or settlement negotiations of contracts. Works with larger and more complex, market/regional/national based groups/systems in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives. The Senior Manager will be responsible for contracting and implementing fee for service and value-based agreements with key physician groups, facilities, and ancillary providers to support commercial and individual exchange networks. This person will also work collaboratively with Aetna and CVS departments to identify initiatives to improve physician performance and quality of care provided to our members. Recruits providers as needed to ensure attainment of network expansion and adequacy targets. Accountable for cost arrangements within defined groups. Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. What You’ll Do Lead end-to-end contract negotiations, execution, and analysis with a focus on hospital, ph