Provider Contracting Lead - Hybrid, Negotiations & Network

Blue Shield of CA; Los Angeles (CA); Hybrid; USD 120,000 - 180,000; Full time

Job summary

Blue Shield of California is seeking a Provider Contracting Specialist, Consultant to manage a portfolio of provider negotiations and contracting initiatives across California. You will independently handle complex negotiations from strategic analysis through execution, ensuring alignment with contracting strategies and approvals.

The role emphasizes affordability, network access, and cross-functional collaboration.

Qualifications

• Bachelor's degree (or equivalent) required with 4 years of relevant experience in lieu of degree.
• 7 years of prior relevant experience in provider contracting and negotiation preferred.
• Advanced knowledge of provider contracting, reimbursement methodologies, and contract language preferred.
• Experience with managed care operations and implications of provider agreements preferred.
• Ability to interpret data, evaluate alternatives, and translate analysis into recommendations.
• Strong portfolio-management skills for multiple negotiations and milestones.

Responsibilities

• Execute an assigned portfolio of provider negotiations and contracting initiatives.
• Independently manage complex negotiations from analysis to execution and resolution.
• Collaborate across the organization to advance affordability, network access, and business objectives.
• Ensure work aligns with contracting strategies, policies, controls, and approval requirements.
• Proactively identify risks and escalate issues requiring broader policy or executive decisions.

Skills

Provider contracting

Negotiation experience

Data interpretation

Financial impact analysis

Portfolio management

Project management

Cross-functional collaboration

Education

Bachelor's degree or High School Diploma/GED with 4 years of relevant experience

Job description

Blue Shield of California is seeking a Provider Contracting Specialist, Consultant to manage a portfolio of provider negotiations and contracting initiatives across California. You will independently handle complex negotiations from strategic analysis through execution, ensuring alignment with contracting strategies and approvals.

The role emphasizes affordability, network access, and cross-functional collaboration.