Senior Manager, Medicaid Network Management (Maryland)

Job Title

Negotiates, executes, conducts high level review and analysis, dispute resolution and / or settlement negotiations of contracts with larger and more complex, market-based group / system providers in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives.

Responsibilities include :

• Analyzes market needs and opportunities for network expansion, identifies gaps in the existing network, and proactively seeks new provider relationships to address those gaps.
• Ensures governance with healthcare regulations and contractual requirements, implementing strategies and processes to adhere to guidelines and requirements.
• Initiates moderate and / or complex contracting activities, including the collection of all required contract and credentialing documents, and obtains the necessary approval of non-standard rates and language modifications to contracts.
• Collaborates on negotiations or may handle contracting and re-contracting discussions with providers, provider groups and / or health systems.
• May participate in various internal and / or external meetings, serving as representative on behalf of the department.
• Supports or assists with operational activities that may include, but are not limited to, database management and contract coordination.
• Provides ongoing recommendations to leadership to guide decision-making and ensure alignment with the organization's strategic goals.
• Coaches and mentors more junior level colleagues in contracting techniques, processes and responsibilities.

Required Qualifications :

Education : Bachelor's Degree preferred or relevant professional experience.

Pay Range : $82,940.00 - $182,549.00

Great benefits for great people :

Application window for this opening will close on : 10 / 31 / 2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.