Provider Contract Specialist (Remote with ~20% Local Travel) – San Antonio, TX

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Alignment Health is seeking a Provider Contract Specialist to support the growth and performance of our provider network in the San Antonio market. In this role, you’ll identify, recruit, and contract with providers—owning the process from initial outreach through signed agreement.

This is not a coordination role. You will be directly negotiating contract terms, handling redlined language, and working through provider pushback while representing Alignment Health’s interests in a professional and solutions-oriented way. Strong Excel skills (e.g., pivot tables, VLOOKUPs) will be important for managing contract data and tracking performance.

The role is primarily remote, with approximately 20% local travel (with mileage reimbursement) to provider offices in the San Antonio / New Braunfels area (no air travel required). When not meeting with providers, you’ll work from home drafting contracts, managing documentation, and collaborating with internal teams including claims, clinical, and network management.

This role is well-suited for someone who is detail-oriented, persistent, and comfortable having direct conversations to move agreements forward.

Job Responsibilities:

Provider Contracting & Network Development

• Recruit new providers in assigned specialty(ies) and regions to support CMS network adequacy and expansion goals.
• Negotiate contract terms and redlined language directly with providers within established parameters, demonstrating sound judgment and the ability to navigate objections without reliance on leadership for routine negotiations.
• Draft and implement contracts in accordance with department guidelines with physicians and/or ancillary providers to support existing and developing markets.
• Review Letters of Interest and distribute to the Contract Manager per department guidelines.
• Secure patient specific Letters of Agreement for non-contracted providers when requested by UM or Market Leadership.

Credentialing, Documentation & Data Management

• Prepare and maintain contract documentation and supporting materials to ensure accuracy, completeness, and audit readiness.
• Request and obtain necessary credentialing information/documents for new providers and monitor credentialing status to ensure timely contract execution and network participation.
• Populate and maintain the contract tracker by promptly and accurately entering key contractual information, verifying data for accuracy and completeness, and ensuring records are consistently up to date.

Compliance, Communication & Provider Relations

• Serve as resource for internal customers for provider contracting questions, ensuring timely professional and effective communication.
• Ensure overall compliance by responding to grievances/appeals and adhering to regulatory and departmental Policy and Procedure guidelines and timeframes.
• Process and communicate provider network changes, including additions, terminations, demographic updates, panel closures, and contractual risk changes in a timely manner to ensure accurate provider directories, Alignment systems, and internal stakeholder awareness.

Cross-Functional Collaboration & Departmental Support

• Participate in interdepartmental meetings and committees to support Network Management initiatives and organizational objectives.
• Contribute to departmental goals by supporting team initiatives and performing other related duties as assigned.
• Other duties and projects not listed above.

Supervisory Responsibilities:  

N/A

Job Requirements:

Required:

• Minimum 5 years’ experience in provider relations / contracting with an HMO or IPA, medical group or institutional provider required
• Demonstrated experience negotiating contract terms and redlined language (beyond facilitating or coordinating contracts) required.

Education:

Required: High School Diploma or GED.  Bachelor's degree or four years additional experience in lieu of education.

Specialized Skills:

Required:

• Strong analytic, quantitative, and problem-solving skills required.
• Strong verbal and written communication skills required.
• Strong presentation skills and ability to appropriately and effectively address diverse audiences required.
• Proficiency in MS Word and Excel required;

Preferred:

• Advanced Excel skills, including pivot tables and VLOOKUPs, strongly preferred.
• Access database proficiency preferred.

Other:

• Office Hours:  Monday-Friday, 8am to 5pm Central Time.  Extended work hours, as needed.
• Maintain reliable means of transportation. If driving, must have a valid driver’s license and automobile insurance.
• Drives approximately 20% of the time to provider sites. 

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $59,877.00 - $89,816.00

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.