Provider Network Negotiator
4 weeks ago
Welcome to Blue Shield of California
About Our MissionWe strive to make a positive change across our industry and communities. Our mission is to ensure all Californians have access to high-quality healthcare at a sustainably affordable price. We achieve this by transforming healthcare through lowering costs, improving quality, and enhancing the member and physician experience.
Salary Range: $109,120.00 - $163,680.00
Your Job Description
This role involves negotiating provider agreements and accountable care collaboration agreements with medical groups/IPAs, hospitals, and ambulatory surgery centers. You will work with cross-functional teams to implement initiatives that help manage the total cost of healthcare across assigned regions. Your responsibilities will include:
- Negotiating product (commercial, Medicare, and Medi-Cal) provider agreements with medical groups/IPAs, hospitals, freestanding ambulatory surgery centers, and accountable care collaboration agreements.
- Collaborating closely with Medical Management, Provider Relations, Network Analytics, and Sales to meet aggressive regional goals.
- Driving alignment with Pricing, Underwriting, and Sales regarding unit cost and other contracting activities.
- Identifying strategic opportunities within local markets.
- Assessing market trends and competitive benchmarks to enhance company positioning.
Requirements
- A college degree in Business, Healthcare Policy, Public Health, or related field or equivalent experience.
- A minimum of 7 years of prior relevant experience.
- Broad healthcare industry knowledge with substantial experience negotiating and managing complex, high-profile provider contracts is preferred.
- Advanced knowledge and skills including technical or functional expertise, business acumen, financial analysis, risk management, delegation, critical thinking, and decision-making is preferred.
- Excellent oral and written communication skills is preferred.
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