Provider Contracting Specialist, Consultant
1 week ago
Blue Shield of CA is seeking a highly skilled Provider Contracting Specialist, Consultant to join our Network Management team. This is a short-term employment position with the potential to be employed for up to 3 years.
About the RoleWe are looking for a seasoned professional to support Medical Group/IPA and Hospital/Facility contracting in Southern California for all Blue Shield products.
Key Responsibilities- Manage comprehensive provider network contract processes, including derivation, implementation, and ongoing support of assigned provider agreements.
- Drive department objectives to achieve timely contract negotiations and implementation that support growth and maintain a strong market position and positive reputation.
- Lead multi-disciplinary teams to implement a new regional structure and help manage the total cost of healthcare within the assigned region.
- Identify opportunities within the assigned local market to drive initiatives that enhance the company's market position.
- Support provider contract negotiations by drafting and managing provider contracts in the contract database.
- Ensure the efficient implementation and administration of provider agreements with a primary focus on medical groups/IPA's hospitals and ASC's.
- Improve and maintain accuracy and integrity of new and existing provider contracts to ensure efficiency in contract administration that supports unit costs savings across all products.
- Bachelor's degree in business, healthcare policy, public health or related field, or equivalent experience.
- At least 7 years of provider contracting/negotiation experience, including experience managing complex negotiations.
- Effective project management skills and understanding of contract administration and general healthcare reimbursement methodologies and knowledge of healthcare provider networks.
- Excellent analytical and problem-solving skills, including knowledge of financial impact analysis.
- Experience in Microsoft Office, including Word, Excel, PowerPoint, and Outlook.
- Strong organizational skills, detail-orientation, and prioritization, and multi-tasking, with ability to manage multiple tasks efficiently.
The pay range for this role is $109,120.00 to $163,680.00 for California.
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade.
Blue Shield salaries are based on a variety of factors, including the candidate's experience, location, and current employee salaries for similar roles.
-
Director, Provider Contracting
4 weeks ago
San Diego, California, United States The Cigna Group Full timeWORK LOCATION: HYBRID position aligned to the San Diego, CA market. The Director, Provider Contracting serves as an integral member of the Provider Contracting Team and reports to the Provider Contracting Senior Manager or VP of Contracting. This role assists in developing the strategic direction and management of the day to day contracting and network...
-
Contract Specialist
1 week ago
San Diego, California, United States Booz Allen Hamilton Full timeJob SummaryWe are seeking a highly skilled Contract Specialist to join our team at Booz Allen Hamilton. As a Contract Specialist, you will play a critical role in supporting our clients with all aspects of the Federal Government contracting life cycle.Key ResponsibilitiesProvide critical support by leveraging available resources to independently review,...
-
Design Consultant
2 days ago
San Diego, California, United States Floor & Decor Full timeJob OverviewThe Design Consultant at Floor & Decor is a key role in our team, responsible for providing exceptional customer service and design expertise to our clients. As a Flooring Specialist, you will be the first point of contact for customers seeking design advice and solutions for their flooring needs.Key ResponsibilitiesCustomer EngagementEngage with...
-
Compassionate Care Provider
2 weeks ago
San Diego, California, United States Senior Living Recruiting Specialist Full timeWe are seeking compassionate Caregivers and Resident Assistants for our premier senior living community.About the Organization:This facility is a Continuing Care Retirement Community (CCRC) that provides assisted living, memory care, and skilled nursing services.Work Environment: Skilled NursingAvailable Positions and Shifts:Resident Assistant...
-
Mortgage Loan Officer Support Specialist
2 weeks ago
San Diego, California, United States Mortgage Consultant - Jeff Stewart Full timeJob OverviewAre you looking to become a vital part of a leading organization in the mortgage sector that values stability, growth, and continuous training? We are seeking a Mortgage Loan Officer Assistant to provide essential support to our loan origination team. In this role, you will manage daily lead tracking, schedule appointments for the mortgage team,...
-
logistics management specialist
1 month ago
San Diego, California, United States Defense Counterintelligence And Security Agency Full timeAs a LOGISTICS MANAGEMENT SPECIALIST you will be responsible for the following duties:LMO lead for Logistics Management Office advising the DCSA Regional Headquarters on matters of facility maintenance, property disposition and the purchase of administrative supplies. Directs, develops and performs logistics management operations that involve planning,...
-
Interim Healthcare Provider
2 weeks ago
San Diego, California, United States LocumJobsOnline Full timePosition Overview:We are looking for a qualified MD to become part of our team. This role offers a flexible schedule with various shifts available. A minimum number of shifts per month is expected, and standard urgent care procedures will be conducted. We offer malpractice insurance, as well as coverage for travel and accommodation expenses.License wait time...
-
Mortgage Lending Support Specialist
2 weeks ago
San Diego, California, United States Mortgage Consultant - Jeff Stewart Full timeJob OverviewAre you seeking an opportunity to work with a prominent entity in the mortgage sector that emphasizes stability, professional growth, and continuous training? We are looking for a Mortgage Loan Officer Assistant to provide direct support to our loan origination team. Your role will involve daily lead tracking, scheduling appointments for the...
-
Provider Relations Specialist
1 week ago
San Diego, California, United States Blue Shield of CA Full timeNetwork Management TeamThe Network Management team is responsible for developing and maintaining all provider networks, including vendor and Plan to Plan relationships, to provide quality and affordable health care services to our members and clients.Job Title: Provider Relations ConsultantThis role reports to the Provider Relations, Senior Manager, and...
-
Mortgage Loan Officer Support Specialist
2 weeks ago
San Diego, California, United States Mortgage Consultant - Jeff Stewart Full timeJob OverviewAre you ready to be part of a prominent organization in the mortgage sector that emphasizes stability, growth, and continuous training? We are seeking a Mortgage Loan Officer Assistant to provide essential support to our loan origination team. In this role, you will manage daily lead tracking, arrange appointments for the mortgage professionals,...
-
Sales and Contract Analyst
1 week ago
San Diego, California, United States AllSTEM Connections Full timeAbout the RoleWe are seeking a highly analytical and detail-oriented Contract and Pricing Specialist to join our team at AllSTEM Connections. As a key business partner, you will be responsible for analyzing pricing and contract-related information, preparing deal analysis, and supporting the maintenance of contract amendments.Key ResponsibilitiesContract...
-
Sap Consultant
2 months ago
San Diego, California, United States Twelve Labs Full timeResponsibilities Consult with organizational leadership to identify and analyze business needs or challenges. Review analyze and modify programming systems to support the organization's SAP applications. Collaborate with cross-functional teams to integrate SAP solutions into existing business processes. Ensure adherence to coding standards documentation...
-
Senior Tax Specialist
2 weeks ago
San Diego, California, United States Pennystarter Consulting PC Full timeJob OverviewWe are seeking a Senior Tax Specialist with a minimum of 5 years of experience, including at least 2 years focused on tax preparation. The ideal candidate will possess exceptional communication skills and be adept at preparing federal and state tax returns for various entities, including individuals, partnerships, S-corporations, and...
-
Human Resources Specialist
2 weeks ago
San Diego, California, United States Global SaaS Provider Full timeJob OverviewWe are looking for a Human Resources Specialist to oversee various HR functions. This role encompasses a wide range of responsibilities, from attracting new talent to ensuring employee satisfaction and managing benefits programs.Key Responsibilities:Identify and recruit potential candidatesFacilitate the onboarding process for new hiresPromote...
-
Home Automation Consultant
6 days ago
San Diego, California, United States Alert 360 Full timeJob OverviewAlert 360 is seeking a highly motivated and results-driven Sales Consultant to join our team. As a Sales Consultant, you will play a critical role in building and maintaining relationships with residential and commercial clients, providing them with comprehensive solutions to meet their home automation and security needs.Key...
-
Contract Management Specialist
6 days ago
San Diego, California, United States SOLV Energy Full timeJob DescriptionSOLV Energy is a leading engineering, procurement, construction (EPC), and solar services provider for utility solar, high voltage substation, and energy storage markets across North America.Job Summary:The Senior Commercial Contracts Manager is responsible for overseeing the commercial contracts surrounding SOLV Energy's Operations and...
-
FP&A Consultant for Financial Strategy
2 weeks ago
San Diego, California, United States Suna Solutions Full timeJob Title: FP&A Consultant / Financial Analysis SpecialistCompensation: $80-$100/hr on W2Contract Duration: 4-6 Months (with potential for extension)Work Arrangement: HybridPOSITION OVERVIEW:The FP&A Consultant will support the Financial Planning & Analysis team, focusing on comprehensive FP&A services for all Selling, General, and Administrative functions....
-
Comprehensive Neurology Care Provider
3 days ago
San Diego, California, United States University of California Full timeJob SummaryThe University of California is seeking a highly skilled Physician - Neurology Specialist to join our esteemed team in the Neurosciences Department. As a key member of our Comprehensive Neurology team, you will provide exceptional clinical care to our patients, working in a full-time capacity at our Rancho Bernardo Clinic.Key...
-
Assembly Specialist
3 days ago
San Diego, California, United States Dawar Consulting Full timeJob Title: Assembler IIIJob Type: Long-term Contract on W2Industry: SemiconductorLocation: San Diego, CAJob Description:We are seeking a skilled Assembly Specialist to join our team at Dawar Consulting. As an Assembly Specialist, you will be responsible for performing a wide variety of electronic or electro-mechanical assembly operations on assemblies or...
-
Compliance Specialist IV
1 month ago
San Diego, California, United States General Atomics Full timeGeneral Atomics (GA), and its affiliated companies, is one of the world's leading resources for high-technology systems development ranging from the nuclear fuel cycle to remotely piloted aircraft, airborne sensors, and advanced electric, electronic, wireless and laser technologies.We have an exciting opportunity for a Compliance Specialist at our Torrey...