• Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers, including SCAs, LOAs, and PPAs. • Manages contract performance in support of network quality, availability, and financial goals and strategies. • Recruits providers to ensure attainment of network expansion and adequacy targets. • Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. • Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities. • Provides network development, maintenance, and refinement activities and strategies in support of cross-market network management unit. Assists with the design, development, management, and or implementation of strategic network configurations, including integration activities. • May optimize interaction with assigned providers and internal business partners to manage relationships and ensure provider needs are met. • Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. • Interprets contractual requirements including federal and state regulations and NCQA.