Senior Provider Contracting Leader (Hybrid)

Blue Shield of CA; Long Beach (CA); Hybrid; USD 150,000 - 210,000; Full time

Benefits offered by this job

Hybrid work schedule

Job summary

Blue Shield of California is seeking a senior negotiator to lead complex provider contracts across commercial, Medi-Cal, and Medicare lines. The role focuses on strategy, financial evaluation, contract language, and post-contract issue resolution, working with hospital systems, medical groups, and community providers.

The position emphasizes affordability, network access, and partnerships while ensuring regulatory compliance and growth objectives.

Qualifications

• Requires a Bachelor's degree or High School Diploma/GED with 4 years of relevant experience in lieu of a degree.
• Requires at least 10 years provider contracting/negotiation experience including managing complex negotiations.
• Requires 5 years working with Medi-Cal, Medicare and Commercial Lines of Business.
• Requires living within 50 miles of Long Beach, San Diego, or Woodland Hills office locations.
• Requires collaborative, proactive leadership and management in executing processes and projects.

Responsibilities

• Lead complex provider negotiations and manage relationships with health systems, hospitals, medical groups, physician organizations and providers.
• Own negotiations from strategy and financial evaluation through contract language, approval, execution, implementation and post-contract issue resolution.
• Drive cross-functional efforts to advance affordability, network access, product strategy, and sustainable provider partnerships.

Skills

Provider negotiations

Negotiation

Strategic leadership

Executive writing

Cross-functional collaboration

Education

Bachelor's degree or equivalent

Job description

Blue Shield of California is seeking a senior negotiator to lead complex provider contracts across commercial, Medi-Cal, and Medicare lines. The role focuses on strategy, financial evaluation, contract language, and post-contract issue resolution, working with hospital systems, medical groups, and community providers.

The position emphasizes affordability, network access, and partnerships while ensuring regulatory compliance and growth objectives.