Senior Manager, Provider Contracts & Strategy (Hybrid)

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

Benefits offered by this job

Annual Incentive Bonus

401(k) with employer match

Paid Time Off (PTO)

Health benefits and wellness programs

Job summary

Blue Cross and Blue Shield of North Carolina is seeking a senior leader to manage and negotiate innovative provider reimbursement initiatives across integrated delivery systems and academic medical centers. You will guide a team in relationship management, contracting strategy, and feasibility modeling to drive large-scale provider network efforts.

The role demands executive-level experience with complex contracts, cross-functional collaboration, and strong financial modeling to forecast cost

Qualifications

• 8+ years of experience required.
• Executive-level provider relationship experience essential.
• High-complexity provider contracting experience.
• Experience with value and pay for performance models.
• Strong financial modeling and cost of care impact understanding.
• Experience working with cross-functional teams within a health plan.

Responsibilities

• Lead team responsible for relationship management and negotiations of complex provider network initiatives.
• Oversee contracting team in building relationships and negotiating innovative provider network strategies.
• Coordinate with internal stakeholders to allocate resources for strategic network initiatives.
• Develop feasibility models and forecast the performance impact of contracting strategies.
• Ensure medical expense targets are met.

Skills

Budgeting

Business Development

Collaboration

Contracting Strategies

Contract Negotiations

Healthcare Operations

Network Development

Policy Development

Project Management

Provider Contracts

Provider Relations

Quality Improvement

Regulatory Compliance

Resource Planning

Stakeholder Management

Strategic Alliances

Education

Bachelor's degree or advanced degree

Tools

[none]

Job description

Blue Cross and Blue Shield of North Carolina is seeking a senior leader to manage and negotiate innovative provider reimbursement initiatives across integrated delivery systems and academic medical centers. You will guide a team in relationship management, contracting strategy, and feasibility modeling to drive large-scale provider network efforts.

The role demands executive-level experience with complex contracts, cross-functional collaboration, and strong financial modeling to forecast cost