Hospital Contracting Lead: Network & Physician Contracts

Horizon Blue Cross Blue Shield of New Jersey; Hopewell (NJ); On-site; USD 120,000 - 180,000; Full time

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a leader to steer the development, negotiation, management, and maintenance of provider contracts across physician organizations, hospitals, and ancillary facilities. The role emphasizes hospital contracting experience in a leadership capacity and collaboration across multiple teams to advance payment models.

The position focuses on negotiating terms, aligning with reimbursement standards, and implementing policy-driven contracting

Qualifications

• Hospital contracting experience in a leadership role.
• Experience with fee-for-service (FFS) and value-based payment contracting initiatives.
• Ability to negotiate provider contracts with hospital executives, physicians, and ancillary providers.
• Experience developing and implementing contracting strategies in healthcare networks.

Responsibilities

• Lead and support development, negotiation, management, and maintenance of provider contracts.
• Collaborate on fee-for-service and value-based payment contracting initiatives with the Director.
• Work with payment evolution and provider experience teams to meet contracting objectives.
• Draft and negotiate provider rate proposals with Medical Economics and Actuary departments.
• Ensure contracting activities comply with Horizon reimbursement standards and regulatory requirements.

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a leader to steer the development, negotiation, management, and maintenance of provider contracts across physician organizations, hospitals, and ancillary facilities. The role emphasizes hospital contracting experience in a leadership capacity and collaboration across multiple teams to advance payment models.

The position focuses on negotiating terms, aligning with reimbursement standards, and implementing policy-driven contracting