Manager of Health Plan Contracting

Location: San Diego, CA Job Type: Full-Time Setting: FQHC / Community Health Center Key Responsibilities Payer Contracting & Reimbursement Lead negotiations and renewals with Medi-Cal managed care plans, Medicare Advantage plans, Covered California plans, commercial insurers, and other payers.Negotiate contract terms and reimbursement rates that support FQHC operations.Ensure Medi-Cal contracts include appropriate FQHC wrap-around payment provisions.Monitor DHCS policies, All Plan Letters (APLs), CMS guidance, and CalAIM initiatives affecting reimbursement and contracting.Maintain payer contracts, rate schedules, renewal timelines, and contractual requirements.Partner with Finance and Revenue Cycle teams to analyze reimbursement, revenue impact, and contract performance.Manage payer relationships, contract interpretation, disputes, and reimbursement issues. Provider Enrollment & Credentialing Coordinate credentialing and re-credentialing for physicians, NPs, PAs, dentists, dental hygienists, behavioral health providers, and other billable clinicians.Manage provider enrollment with Medi-Cal, Medicare, managed care plans, and commercial payers.Maintain accurate provider enrollment records, rosters, and required documentation.Coordinate provider onboarding and payer participation dates.Conduct required exclusion screening and maintain compliance documentation. Compliance & Reporting Ensure contracting and credentialing activities meet applicable FQHC, federal, California state, and payer requirements.Support required reporting, audits, and regulatory reviews.Maintain contracting and credentialing policies and procedures.Work with leadership, Compliance, HR, Finance, Revenue Cycle, and Clinical teams on payer and enrollment matters. Required Qualifications Bachelor's degree in Health Administration, Business, Healthcare Management, or related field, or equivalent experience.3-5 years of experience in managed care contracting and/or provider credentialing.At least 2 years of experience in a California community health center, FQHC, or Medi-Cal participating safety-net organization.Strong knowledge of FQHC PPS, Medi-Cal FQHC wrap-around payments, and encounter-based billing.Working knowledge of California Medi-Cal managed care, DHCS policies/APLs, and CalAIM.Familiarity with HRSA Health Center Program requirements.Experience with credentialing/provider enrollment platforms and DHCS provider enrollment systems.Strong contract interpretation, negotiation, analytical, and financial skills.Excellent written and verbal communication skills. Preferred Qualifications CPCS or CPMSM certification.Experience negotiating with California Medi-Cal Local Initiatives or County Organized Health Systems (COHS).Experience with CalAIM ECM and Community Supports.Dental and behavioral health credentialing/Medi-Cal billing experience.Experience supporting HRSA site visits or DHCS audits. Additional Requirements Current BLS/CPR certification from an approved provider.Ability to complete required background and compliance checks.Proficiency with Microsoft Office, Word, and Excel.Strong organization, attention to detail, confidentiality, and time-management skills.Ability to work independently and collaborate across multiple departments.