Senior Provider Partner

1 week ago

Eagan, United States Blue Cross and Blue Shield Association Full time

About Blue Cross

Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us.

How Is This Role Important to Our Work?

The provider partner position develops and maintains long-term, trusted relationships with provider partners. The Senior role works to ensure the strategy and deliverables for each individual and unique provider relationship are met. At times the Senior may partner with the providers in the transition from fee for service to value-based payment models or other collaborative initiatives. Critical to the role is to also partner internally with provider stakeholders to ensure the voice of the provider is heard and applicable action is taken. The Senior Provider Partner will also support the development of recommendations and strategies of how to improve and expand the current or future partnership, and negotiate all aspects of the contractual terms with assigned providers.

A Day in the Life:

* Develops and builds strong relationships with provider accounts and manages all aspects of the provider relationship.
* Develop contractual partnerships with provider/vendors who provide emerging behavioral health virtual care models


* Possesses and applies a broad knowledge of negotiation principles, practices and procedures to bring contracts to signature while maintain deadlines and remaining within budget targets.
* Creates, implements and executes annual work plans to support existing or newly assigned strategic provider accounts to ensure timely performance of contractual duties.
* Prepares management and status reports that summarize the status and completion of ongoing contractual duties, management of the provider relationship, and contract negotiations for leadership and peers across the provider partnership team on difficult issues.
* Participates on and may lead cross-functional teams that help further develop new models of strategic relationship options that can improve network performance.
* Identifies and defines business problems, strategies and tactics to provide solutions that provide value to Blue Cross, the provider and Blue Cross members. Responsible to execute on the solutions.
* Translates complex data in conjunction with network finance or other corporate analysts and interprets contracting and financial data for providers to identify solutions to non-standard requests and problems.
* Works with minimal guidance and proactively researches, analyzes and interprets key information on provider organizations, provider negotiation staff, and market contracting benchmarks to enhance negotiation effectiveness.
* Ensures that contracts and payment terms are negotiated in accordance with established contract administration policies and procedures, including regulatory requirements.
* Coaches, provides feedback and guides others through the complex negotiation process and acts as a resource for those with less experience within the team.

Nice to Have:

* Bachelor's degree.
* Exhibits strong relationship management skills.
* Flexible in handling work flow and in working with other stakeholders.
* Displays strong ability to lead cross-functional teams.
* Demonstrated project management skills.
* Excellent communications and interpersonal skills (internal/external).
* Ability to work across systems and functions to facilitate solutions and capabilities development.
* Demonstrated creativity and curiosity in solution development with strong sense of urgency.
* Positive thinker/self starter.
* Skillful negotiator, ability to influence internal and external customers.

Required Skills and Experiences:

* 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.

Role Designation:

Hybrid Remote

Role designation definition: Teleworking is working full time remote. Hybrid is a combination of working onsite and remotely. Onsite is full-time onsite.

Make a difference

Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.

Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talent.acquisition@bluecrossmn.com.

All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.

Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

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