Alignment Health · 1 month ago
Senior Manager, Provider Contracting
El Paso, TX
Full-time
Onsite
Senior Level
5+ years expAlignment Health is a company focused on enhancing provider network performance and member satisfaction. The Sr. Manager, Provider Contracting is responsible for contracting with various provider types, leading network strategy, and ensuring operational excellence while overseeing a team and collaborating with other departments.
Health CareHospitalMedicalMedical DeviceWellness
Hiring Manager
Abigail Gomez
Responsibilities
Partner with Network Management leadership to develop and execute market-specific contracting strategies
Recruit and onboard providers to eliminate network gaps and support regional growth
Negotiate, renegotiate, and finalize contracts with primary care providers, specialists, hospitals, ancillary providers, and groups/IPAs
Ensure accurate contract setup and administration across all agreements
Lead, mentor, and coach staff to support performance, skill development, and career growth
Oversee day-to-day network operations to ensure compliance with company standards
Develop provider education materials to support adherence to company requirements
Create agendas and lead Joint Operations Meetings focused on performance improvement, operational issue resolution, and provider support
Oversee New Provider Orientations and Contract Orientation sessions
Address issues related to utilization management, financial performance, enrollment, appeals and grievances, provider terminations, continuity of care, and marketing activities
Execute regional workplans by monitoring performance metrics, updating progress, and communicating results internally and externally
Ensure accurate and timely reporting on eligibility, capitation, network contacts, risk sharing, claims timeliness, utilization data, encounter submissions, and audit compliance
Align goals and objectives with Network Management leadership to meet departmental KPIs and support organizational growth
Apply contracting expertise to research and resolve complex issues involving shared risk pools, claims, appeals, and eligibility
Respond professionally and promptly to provider and member grievances
Develop and implement departmental policies and procedures; interpret company policies as needed
Represent the department in interdepartmental meetings and on designated committees
Support additional initiatives and projects as assigned
You will oversee assigned staff and may manage third-party vendors or student workers
Responsibilities include recruiting, selecting, onboarding, and training employees
Assigning workload and monitoring performance
Conducting evaluations and providing ongoing coaching
Addressing performance issues and maintaining a supportive, accountable team environment
Qualification
Required
5–7 years of experience in an HMO, managed care organization, IPA/Medical Group, institutional provider, or health insurance company
At least 5 years of direct experience in managed care contracting, including strong knowledge of Medicare Advantage regulations
Prior supervisory or team leadership experience required
Bachelor's degree or equivalent work experience required
Proficiency in MS Office with strong skills in Word and Excel
High attention to detail and accuracy
Ability to read, interpret, and apply contracts, operational manuals, and regulatory guidance
Strong written and verbal communication skills, including the ability to present to providers and internal teams
Ability to calculate fee schedules, per diem rates, discounts, commissions, percentages, and other financial metrics
Strong analytical, reasoning, and problem-solving capabilities
Ability to synthesize and apply complex information to real-world situations
Reliable transportation; valid driver's license and auto insurance if driving
Ability to work extended hours when needed
Travel to provider sites approximately 20–40% of the time
Company
Alignment Health
Alignment Health provides eldercare services.
501-1000 employees
H1B Sponsorship
Alignment Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (12)
2023 (17)
2022 (13)
2021 (11)
2020 (6)
Funding
Current Stage
Public CompanyTotal Funding
$696.05MKey Investors
K2 HealthVenturesWarburg PincusGeneral Atlantic
2024-11-15Post Ipo Debt· $321.05M
2024-01-09Private Equity
2021-03-26IPO
Leadership Team
Dawn Maroney
President, Markets & CEO of Alignment Health Plan
John Kao
CEO and Founder
Recent News
Company data provided by crunchbase