Provider Contracting Specialist, Consultant

4 weeks ago


Lodi, California, United States Blue Shield of CA Full time

Job Summary:

This is a short-term employment position that can be employed up to 3 years. The role is part of the Network Management team, which handles provider contracting and provider relations statewide.

Key Responsibilities:

  1. Support Medical Group/IPA and Hospital/Facility contracting in Southern California for all Blue Shield products.
  2. Manage comprehensive provider network contract processes, including derivation, implementation, and ongoing support of assigned provider agreements.
  3. Drive department objectives to achieve timely contract negotiations and implementation.
  4. Support initiatives to maintain a strong market position and positive reputation in the market.

Work Environment:

The Provider Contracting Specialist, Consultant will report to the Senior Manager of Provider Contracting. The role will interact with multi-disciplinary teams, including Law Department, Medical Management, Model Contracts, Provider Relations, Analytics, and Sales.

Requirements:

  1. Bachelor's degree in business, healthcare policy, public health, or related field, or equivalent experience.
  2. At least 7 years of provider contracting/negotiation experience, including managing complex negotiations.
  3. Effective project management skills, understanding of contract administration, and general healthcare reimbursement methodologies.
  4. Excellent analytical and problem-solving skills, including knowledge of financial impact analysis.
  5. Experience working with a contract management system is preferred.

Pay Range: $109,120.00 to $163,680.00 for California.



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