Senior Manager, Innovative Provider Contracting - Hybrid

Habitat For Humanity Of Durham; Durham (NC); Hybrid; USD 131,000 - 209,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

401(k) match

Paid time off

Job summary

Blue Cross NC is seeking a senior leader to manage complex provider reimbursement initiatives across integrated healthcare delivery systems and hospitals. You will oversee the contracting and network strategies, negotiate with major providers, and drive feasibility models to forecast performance and costs.

The role requires collaboration with internal stakeholders, limited travel within North Carolina, and a hybrid/onsite work arrangement.

Qualifications

• Bachelor's or advanced degree required.
• 8+ years of experience in health plan or provider contracting.
• In lieu of degree, 10+ years experience.

Responsibilities

• Lead team to manage complex provider reimbursement initiatives with healthcare systems and providers.
• Lead contracting team for innovative provider network strategies.
• Drive and negotiate contracts and provider network opportunities.
• Collaborate with internal stakeholders to allocate resources (FTEs, technology).
• Lead negotiations with academic medical centers and multispecialty providers.
• Develop feasibility models forecasting contracting impacts and cost of care.

Skills

People leadership

Provider contracting

Financial modeling

Healthcare networks

Education

Bachelor's degree or higher

Job description

Blue Cross NC is seeking a senior leader to manage complex provider reimbursement initiatives across integrated healthcare delivery systems and hospitals. You will oversee the contracting and network strategies, negotiate with major providers, and drive feasibility models to forecast performance and costs.

The role requires collaboration with internal stakeholders, limited travel within North Carolina, and a hybrid/onsite work arrangement.