Senior Manager, Provider and Facility Contracting

About the Role

Aligned with HMSA mission, vision, values, and provider strategy, you are responsible for leading and managing the provider contracting and negotiated arrangements function in Provider Services. This includes overseeing the work of the employees in the Contracting and Facility Relations (CFR) Department as well as outside contracted vendors. You will build a high-performing contracting and contract management team to ensure the overall provider contracting function operates smoothly, efficiently, and effectively.

Pay

$86,500 - $179,500, with eligibility for an incentive bonus. Individuals typically begin between the minimum to middle of the pay range.

Responsibilities

• Manage CFR Team:
  • Leadership: Provide direction and guidance to staff on provider issues, reinforcing partnership and alignment to company and department values and goals. Hold staff accountable for meeting commitments, including monitoring work quality and timeliness. Responsibilities include:
    • Reviewing and guiding staff on contract negotiations.
    • Coordinating training for Provider Services staff responsible for contracting operations.
    • Ensuring legal and regulatory compliance of the provider contracting function by collaborating with other HMSA departments (e.g., Compliance and Ethics, government LOBs).
  • Teaming: Build and sustain a high-performing provider contracting team. Attract and retain talent to meet current and future business needs while developing employees to align with both their career goals and the company’s objectives.
  • Managing Execution: Delegate tasks, remove obstacles, and prioritize work to meet organizational goals. Identify development areas for direct reports, provide feedback, and assign tasks for continual improvement.
  • Oversee CFR Operations: Manage day-to-day operations, including:
    • Overseeing personnel, developing performance measures, conducting reviews, and determining salary adjustments.
    • Hiring and dismissing employees as necessary.
    • Managing contract operations (e.g., accuracy of eVIPs contract records, system testing, payment terms, negotiation timelines, compliance oversight) to mitigate risk and ensure business continuity.
  • Compliance: Ensure provider contracts and related policies are administered properly, aligning contractual terms with claims processing, utilization management, and appeals. Coordinate internally with departments such as Professional Reimbursement, Claims Administration, Medical Management, Legal, and Compliance.
• Provider Strategy:
  • Participate in the development, support, and implementation of HMSA’s provider strategy, including contracting strategies for hospitals and negotiated/facility arrangements.
  • Engage in corporate strategy initiatives involving providers, such as ACOs, value-based arrangements, payment transformation, and strategic vendor relationships.
  • Ensure staff are informed and aligned with corporate strategy and initiatives.
  • Identify and coordinate the development of new contracts and strategies to meet evolving provider community needs and HMSA’s strategic goals.
• Provider Partnership:
  • Develop and maintain partnerships with strategic provider partners.
  • Conduct provider contracting negotiations.
  • Build positive working relationships with hospital administrators, financial management staff, physician organization leadership, and quality improvement staff.
  • Represent Provider Services on cross-functional projects and teams.
  • Provide guidance on contract matters to operational staff and train new stakeholders on contracting practices.
• Perform other miscellaneous responsibilities and duties as assigned.

Requirements

• Bachelor’s degree and six years of related work experience, or an equivalent combination of education and experience.
• Two years of previous management/supervisory experience.
• Experience in a highly regulated industry.
• Experience negotiating contracts and/or vendor/contract management.
• Strong communication skills, both verbal and written.
• Ability to establish and maintain effective working relationships.
• Excellent interpersonal, analytical, leadership, planning, and organizational skills.
• Proficiency in Microsoft Office applications (Word, Excel, Outlook, PowerPoint).

Schedule

Full-time, exempt position. Hybrid work environment; must reside on Oahu.