Contracting Systems Manager - Health Plan

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults through Medicare Advantage, fully integrated care models, primary care, and next-generation care delivery.

About the role

The Contracting Systems Manager serves as the contracting subject matter expert responsible for ensuring provider contract intent is accurately translated into system configuration and operational outcomes. This role provides oversight of contract-to-configuration alignment, testing validation, discrepancy resolution, and implementation readiness to reduce financial, operational, and provider disruption risk. You will partner closely with Configuration, Claims, IT, Network Management, Provider Operations, Finance, and implementation teams to ensure provider contract requirements are accurately operationalized and sustained throughout the contract lifecycle.

Responsibilities

• Serve as the Contracting subject matter expert for QNXT, contract management system, and other enterprise system implementations.
• Provide oversight and validation of contract-to-configuration alignment to ensure provider agreements are accurately operationalized.
• Review complex reimbursement methodologies and contract provisions to identify risks associated with system configuration and claims adjudication.
• Lead contract-related testing activities including UAT, parallel testing, payment validation, and go-live readiness assessments.
• Identify, investigate, and escalate discrepancies between contract intent and system outcomes.
• Partner with Configuration, Claims, IT, Provider Operations, and implementation teams to develop solutions for contract implementation issues.
• Establish and maintain processes and controls that support ongoing contract-to-system accuracy.
• Serve as the primary business resource for contract implementation, renewals, amendments, and system enhancement initiatives.
• Analyze operational and financial impacts of contract implementation decisions and provide recommendations to leadership.
• Lead special projects and process improvement initiatives supporting enterprise contracting and payment accuracy objectives.
• Actively support the achievement of SCAN’s Vision and Goals.
• Other duties as assigned.

Requirements

• Bachelor's degree or equivalent experience in Healthcare Administration, Business Administration, Finance, Information Systems, Public Health, or related field.
• 5+ years of experience in managed care, provider contracting, network management, claims operations, configuration support, healthcare systems implementation, or related healthcare or health insurance plan operations.
• Experience interpreting and applying complex provider contract terms, reimbursement methodologies, and payment arrangements.
• Experience participating in large-scale operational or technology implementations.
• Experience collaborating across multiple business functions, including Contracting, Claims, Configuration, Operations, Network Management, Finance, and Information Technology.
• Experience supporting testing, validation, issue resolution, implementation readiness, and production support activities for business-critical systems.
• Strong analytical experience identifying operational, financial, payment, and implementation risks and developing recommendations for resolution.
• Microsoft Office (Word, Excel, PowerPoint, Teams, Outlook) at advanced skill level.

Qualifications

• Experience with QNXT or other healthcare claims administration platforms.
• Experience supporting Contract Lifecycle Management systems or contract repository solutions.
• Experience with user acceptance testing, parallel testing, payment validation, and production readiness activities.
• Knowledge of provider configuration, claims adjudication, fee schedules, value-based reimbursement models, delegated risk arrangements, and Medicare Advantage operations.
• Experience supporting enterprise transformation initiatives, system conversions, or business process redesign efforts.
• Experience facilitating discussions between technical, operational, and business stakeholders.
• Experience developing implementation standards, quality controls, workflows, and operational procedures.
• Project management or process improvement experience preferred.

Benefits

• Robust Wellness Program
• Generous paid-time-off (PTO)
• Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
• Excellent 401(k) Retirement Saving Plan with employer match and contribution
• Robust employee recognition program
• Tuition reimbursement

Pay

Base salary range: $92,400 to $133,671 per year

Internal title: Contracts Manager

An annual employee bonus program

Schedule

Work Mode: Mostly Remote