Finance jobs in San Diego, CA

About the role

The Manager of Health Plan Contracting is responsible for leading all aspects of insurance contract negotiations for the health center. This position ensures the organization maintains favorable payer relationships, maximizes reimbursement in alignment with FQHC cost-based payment methodologies, and sustains full credentialing compliance across all funding sources. The role works closely with Finance, Operations, Clinical Leadership, and Compliance to protect the center's Section 330 grant obligations and sliding fee discount program integrity. The Manager serves as the organization's subject matter expert on California Medi-Cal FQHC policy, managed care contracting, and state-specific enrollment requirements.

What you'll bring

• Bachelor’s degree in health administration, business, or a related field; or equivalent combination of education and experience.
• Minimum 3–5 years of experience in managed care contracting and/or provider credentialing, with at least 2 years in a California community health center, FQHC, or Medi-Cal participating safety-net organization.
• Demonstrated knowledge of FQHC Prospective Payment System (PPS), Medi-Cal FQHC wrap-around payment methodology, and encounter-based billing requirements.
• Working knowledge of California Medi-Cal managed care plan landscape, DHCS All Plan Letters, and CalAIM program structure.
• Familiarity with HRSA Health Center Program compliance requirements and the Health Center Compliance Manual.
• Proficiency with credentialing platforms (e.g., Symplr, Modio, CredentialStream, or similar) and the DHCS Provider Enrollment web portal.
• Ability to interpret complex contract language, rate structures, and reimbursement calculations
• strong analytical and financial modeling skills.
• Excellent written and verbal communication
• demonstrated ability to negotiate professionally with health plan representatives and government agencies.
• Certification must include an in-person, hands-on skills assessment.
• Strong presentation skills and ability to create needed educational materials.