Senior Advisor Contract Management and Execution

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Job Category:
Provider Relations

Department:
Provider Network Management

Location:

Los Angeles, CA, US, 90017

Position Type:
Full Time

Requisition

Salary Range:$(Min.) -$(Mid.) -$(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.

6 open positions:

The Senior Advisor Contract Management and Execution manages provider contracting activities from initial opportunity through final execution, including reimbursement evaluation, negotiation strategy, contract language, approvals, and renewals. This position develops and maintains contracting work plans and documentation, leads provider negotiations within established parameters, and serves as the primary contracting representative for assigned providers.

The Senior Advisor identifies and addresses renewal and amendment needs, escalates risks as necessary, and consistently communicates the health plan’s contracting positions, ensuring strong provider relationships and organizational integrity.

This position collaborates with key stakeholders to review programs, projects, processes, procedures, and policies; and to conduct end-to-end root cause analysis to enhance and improve outcomes and remediate issues to comply with the national and statewide standards and regulations.

Provides expert advice to various teams, including program and product development, marketing, and customer service, on various relevant topics.

Serves as the expert and steward of provider contracting activities, guiding each engagement from initial opportunity to final execution. Manage reimbursement and financial evaluations, negotiation strategy formulation, contract language negotiation, internal review and approval processes, and the full spectrum of contract execution, amendment, and renewal activities.

Develops, maintains, and manages robust contracting work plans and timelines, ensuring seamless stakeholder approvals and meticulous documentation of all contracting activity.

Leads provider negotiations consistently aligning proposed terms with established financial, contractual, legal, and strategic parameters. Navigates, modifies, and negotiates provider agreements, exhibits, reimbursement schedules, amendments, counter proposals, concessions, and closing strategies in accordance with established organizational guidelines and approval parameters.

Escalates matters when proposed terms exceed established parameters or present material risk. Identifies upcoming contract renewal dates, notice requirements, expiring rate terms, and amendment needs, and initiates provider negotiations to minimize contract expiration or continuity risk.

Serves as an expert on contracts by communicating contracting positions, requirements, and negotiation parameters to provider organizations.

Develops reports, analyzes data and provides presentation on status of areas of responsibilities on an as needed basis in support of department operations.

Partners with the management to communicate compliance and operational priorities and provide feedback or follow-ups to key stakeholders.

Acts as the point of contact for key strategic initiatives.

Provides expert advice to various…