Manager of Health Plan Contracting

About the Company

Antidote Health is a tech- driven health insurance company on a mission to make healthcare easy, accessible, and more affordable. We’re rethinking how healthcare works—using technology to remove the friction, complexity, and delays that define the traditional system. Instead of navigating paperwork, long waits, and disconnected experiences, we’re building a simpler, more connected way for people to get care. 

Our platform combines health coverage, virtual care, and a modern member experience into one seamless system designed to help people actually use their benefits.  We offer Affordable Care Act (ACA) health plans in Arizona and Ohio, and we’re growing quickly. We’re building a company focused on solving real problems—with real impact on people’s lives.

Position Overview

The Manager of Health Plan Contracting is responsible for managing business and enterprise contracting for Antidote Health. This includes negotiation and execution of vendor, technology, and business agreements, as well as provider agreements where applicable, in compliance with CMS, ACA Marketplace, and state-specific requirements. A strong preference will be given to candidates who also possess healthcare provider contracting experience. The Manager partners cross-functionally with legal, compliance, finance, information technology, information security, and network development teams to develop, execute, and maintain contracts that ensure access, quality, and value. The role also involves ensuring data integrity in contract management systems, managing renewals and amendments, supporting regulatory filings, and implementing contracting strategies that align with Antidote’s operational and financial objectives.  Candidates without healthcare provider contracting experience will receive structured training to develop competency in reviewing and negotiating healthcare provider agreements as part of their onboarding and professional development.

Key Responsibilities

• Manage end-to-end business and enterprise contracting processes, including vendor, technology, SaaS, and operational agreements.
• Negotiate contract terms, rates, and payment structures consistent with Antidote’s operational and financial goals.
• Manage relationships and performance of third-party contracting partners or vendors, ensuring service-level adherence, data accuracy, and compliance with Antidote’s contracting standards and regulatory obligations.
• Collaborate with Legal, Compliance, and Network Development to ensure agreements meet CMS, ACA Marketplace, and state-specific regulatory requirements, including the ability to conduct independent regulatory research to identify and assess applicable federal and state requirements.
• Maintain an organized repository of executed agreements, amendments, approved alternate contract language, and key contract metadata in alignment with operational workflows.
• Develop and maintain contract management dashboards and key performance indicators (KPIs) to track agreement status, key dates, renewals, contracting turnaround time, and compliance metrics.
• Manage end-to-end procurement processes, including RFPs, RFIs, RFQs, sole-source justifications, vendor evaluation and scoring, contract award, amendments, change requests, and ongoing vendor performance management.
• Review, update, and maintain contracting policies, procedures, and templates.
• Lead or support internal and external audits related to contracting.
• Support development and implementation of new provider programs, incentive arrangements, and payment methodologies.
• Participate in system implementations and data integrations affecting contract and provider records.

Healthcare Provider Contracting Responsibilities

The following responsibilities will be assigned based on the candidate’s prior healthcare provider contracting experience or upon successful completion of structured training:

• Develop, negotiate, and draft Single Case Agreements (SCAs) and Letters of Agreement (LOAs) for out-of-network or case-specific services, ensuring appropriate reimbursement terms, utilization controls, and compliance with applicable regulations.
• Support healthcare provider contracting activities, including negotiation and execution of provider agreements.
• Coordinate with Network Development and Credentialing to ensure seamless onboarding and network integration of contracted providers.

Qualifications

Required:

• Juris Doctorate strongly preferred; attorney license eligibility preferred.
• Equivalent combination of education and progressively responsible experience in business contracting, managed care, or a related field may be considered in lieu of degree.
• Minimum of 4 years of progressive experience in business contracting, including negotiation and management of vendor, technology, or operational agreements (with Juris Doctorate).
• At least 2 years of supervisory or team leadership experience preferred.
• Strong understanding of contract reimbursement methodologies.
• Excellent analytical, communication, and organizational skills.
  

Preferred:

• Experience negotiating healthcare provider contracts and familiarity with CMS and ACA Marketplace contracting requirements and state-level regulatory standards.
• Experience with end-to-end procurement processes, including Requests for Proposal (RFPs), Requests for Information (RFIs), Requests for Quotation (RFQs), sole-source justifications, vendor evaluation and scoring, contract award, amendments, change requests, and ongoing vendor performance management.
• Experience with contract management systems or provider data platforms.

Competencies

• Strong negotiation and relationship-management skills with vendors, provider groups, and business partners.
• Proficiency in developing, implementing, and monitoring contracting policies and workflows.
• Ability to interpret and apply regulatory and contractual requirements to business and operational contexts.
• Proficiency in end-to-end procurement processes, including RFPs, RFIs, RFQs, sole-source justifications, vendor evaluation frameworks, contract award, amendments, change requests, and vendor performance management.
• Comprehensive understanding of CMS, ACA Marketplace, and state-specific network and contracting regulations preferred.
• Experience conducting contract-related audits and preparing for regulatory reviews.
• Ability to create corrective action plans and monitor contract compliance metrics.
• Competence in using data and KPIs to implement process improvements.
• Proven ability to manage multiple priorities in a fast-paced, growth-stage environment.
• Build and maintain positive working relationships with internal and external stakeholders.

Compensation and Benefits

• Base salary range: $145,000 – $175,000 (commensurate with experience and location)
• Eligibility for equity
• Comprehensive benefits package including medical, dental, vision
• 401(k) 
• Paid vacation and sick time and company holidays

Company Standards and Expectations

• Employment is at-will, meaning either the employee or the company may terminate employment at any time, with or without cause, in accordance with applicable law
• Employees are expected to adhere to all company policies, including confidentiality, data protection, and code of conduct
• Responsibilities may evolve based on business needs, and flexibility is expected as the company scales
• Compliance with all applicable federal, state, and local laws and regulations is required

Equal Opportunity Statement

Antidote Health is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other protected status under applicable law.