Senior Manager, Provider Contracting - Hybrid-Flex

Blue Cross and Blue Shield of North Carolina; Durham (CA); Hybrid; USD 131,000 - 209,000; Full time

Benefits offered by this job

Hybrid work model

Remote Flex

Hybrid-Flex role

Job summary

Blue Cross and Blue Shield of North Carolina seeks a senior leader to manage and advance complex provider reimbursement initiatives within a broad network of integrated delivery systems. The role emphasizes negotiation, collaboration with hospitals, and strategic provider relationships to maintain network leadership.

You will lead a team, guide feasibility modeling, and align contracting strategies with medical expense targets, in a Hybrid Flex environment based near Durham, NC.

Qualifications

• Bachelor’s or advanced degree required.
• 8+ years of experience; in lieu of degree, 10+ years.
• Executive level provider relationship experience essential.
• High-complexity provider contracting with value and pay-for-performance models.
• Experience with cross-functional health plan teams.

Responsibilities

• Lead team managing complex provider reimbursement initiatives with integrated systems.
• Lead contracting team for provider network strategies.
• Drive and facilitate innovative provider network opportunities and negotiate contracts.
• Coordinate discussions with internal/external stakeholders to align network initiatives.
• Collaborate to allocate resources for strategic network initiatives.
• Lead negotiations with key providers such as academic medical centers.
• Develop feasibility models and forecast contracting impact.
• Develop strategy to meet medical expense targets.

Skills

Provider reimbursement initiatives

Provider network strategies

Contract negotiations

Relationship management

Education

Bachelor’s degree or higher

Job description

Blue Cross and Blue Shield of North Carolina seeks a senior leader to manage and advance complex provider reimbursement initiatives within a broad network of integrated delivery systems. The role emphasizes negotiation, collaboration with hospitals, and strategic provider relationships to maintain network leadership.

You will lead a team, guide feasibility modeling, and align contracting strategies with medical expense targets, in a Hybrid Flex environment based near Durham, NC.