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Provider Contract Specialist III (Los Angeles, CA, US, 90017) @ L.A. Care Health Plan

Los Angeles, California, USOnsiteFull-time
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About this role

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (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. Job Summary (6 positions available) The Provider Contract Specialist III leads the negotiation, evaluation, and execution of high-value and complex contracts across professional, facility, vendor, and ancillary providers. This role bridges legal, finance, and operational teams to ensure contract terms align with organizational strategy. The specialist optimizes provider networks, manages amendments and compliance, and analyzes performance metrics, operating across multiple provider types and regions, the specialist resolves escalated issues and drives process improvement, advancing organizational goals and maintaining robust provider relationships. Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff. Duties Serves within the contracting team, entrusted with leading the negotiation, evaluation, and execution of contracts across professional, facility, vendor, and ancillary providers. Manages high-value and complex agreements, requiring a nuanced understanding of both organizational strategy and industry dynamics. Acts as a bridge between legal, finance, and operational stakeholders, facilitating critical discussions and decisions to ensure contract terms align seamlessly with the company’s strategic objectives. Identifies opportunities for expansion and quality improvement, directly contributing to the organization’s competitive edge and service excellence by optimizing provider networks. Manages contract amendments, template management, and rigorous compliance with regulatory requirements. Tracks and analyzes contract performance metrics, offering actionable recommendations that drive continuous improvement and operational efficiency. Represents the department in cross-functional initiatives and provider meetings, ensuring the contracting function is integrated and responsive to broader organizational needs. Handels a broader and more complex caseload often spanning multiple provider types or regions. Operates with significant autonomy and authority. Manages escalated issues and resolving disputes related to contract terms and execution, demonstrating both leadership and problem-solving acumen. Drives process improvement, participates in training, and supports the organization’s mission through effective contract management by being a supportive strategic partner. Maintain robust provider relationships, ensuring compliance, and advancing organizational goals. Applies subject matter expertise in evaluating business operations and processes. Identify areas where technical solutions would improve business performance. Consult across business operations, provide mentorship, and contribute specialized knowledge. Ensure that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provide training and recommend process improvements as needed. Performs other duties as assigned. Duties Continued Education Required Bachelor's Degree In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree in Business or Related Field Experience Required : At least 4 years of experience in contract management with demonstrates a proven track record in negotiating, executing, and ensuring regulatory compliance for complex agreements. Professional experience as a strategic partner, capable of advancing organizational goals through effective contract management and stakeholder collaboration. Preferred: Experience in cross-functional collaboration, representing the contracting function in broader organizational initiatives and provider meetings. Skills Required: Demonstrate advanced expertise in contract negotiation and management, handling high-value and complex agreements across multiple provider types. Strong analytical skills with the ability to evaluate contract performance and ensure compliance with regulatory standards. Stakeholder management, bridging legal, finance, and operations, and mentoring skills. Autonomy, leadership, and problem-solving abilities are critical for managing escalated issues and driving process improvements that align with organizational strategy. Strong leadership and mentoring skills, enabling them to guide junior specialists and foster a culture of continuous improvement within the contracting team. Preferred: Healthcare Network Management and Healthcare Operations skills with the ability to excel at optimizing provider networks, identifying opportunities for expansion and quality improvement. Knowledge of change management, advanced contract management technology, and a commitment to continuous learning further enhance the Specialist’s impact and adaptability. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information Required: Travel to offsite locations for work required. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO)

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