Senior Manager, Provider Contracting & Network Strategy

NC Health Affiliates; Durham (NC); Hybrid; USD 131,000 - 209,000; Full time

Benefits offered by this job

Health benefits

Parental leave

Tuition reimbursement

401k match

Hybrid Flex environment

Work-life balance

Job summary

Blue Cross NC seeks an executive-level leader to manage the assessment, development, and negotiation of the most complex provider reimbursement initiatives with integrated delivery systems and key providers. The role directs a contracts-focused team and collaborates across stakeholders to ensure strategic network opportunities are implemented effectively.

In addition to strong financial modeling and cost of care insights, the position requires extensive provider relationship experience and the

Qualifications

• Bachelor’s or advanced degree where required; in lieu of degree, 10+ years’ experience.
• 8+ years of experience in leadership and contract-related roles.
• Executive-level provider relationship experience is essential.

Responsibilities

• Lead team responsible for assessment, development, articulation, negotiation and implementation of complex provider reimbursement initiatives.
• Oversee relationships with integrated delivery systems, hospital systems and key providers.
• Direct contracting team on building relationships, research, analysis, development and negotiation of network strategies.
• Drive next-generation provider network opportunities and implement strategies into contracts.
• Collaborate with internal stakeholders to allocate resources (FTEs, technology, etc).
• Lead negotiations with academic medical centers and multispecialty providers.
• Develop feasibility models and forecast financial impact of contracting strategies.
• Develop strategies to ensure medical expense targets are met.

Skills

Budgeting

Business Development

Collaboration

Contracting Strategies

Contract Negotiations

Healthcare Operations

Network Development

Policy Development

Education

Bachelor's degree

Job description

Blue Cross NC seeks an executive-level leader to manage the assessment, development, and negotiation of the most complex provider reimbursement initiatives with integrated delivery systems and key providers. The role directs a contracts-focused team and collaborates across stakeholders to ensure strategic network opportunities are implemented effectively.

In addition to strong financial modeling and cost of care insights, the position requires extensive provider relationship experience and the