Senior Provider Contracts Strategist

Blue Shield of CA; San Diego (CA); Hybrid; USD 150,000 - 190,000; Full time

Job summary

Blue Shield of California is seeking a senior leader in Government Programs to negotiate provider contracts across commercial, Medi-Cal, and Medicare lines, building accessible, high-quality networks.

You will lead strategy to post-contract issue resolution and cross-functional initiatives to improve affordability and member experience.

Located within 50 miles of Woodland Hills, San Diego, or Long Beach offices, this hybrid role emphasizes leadership development and growth.

Qualifications

• Requires a Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
• Requires at least 10 years provider contracting / negotiation experience including experience managing complex negotiations
• Requires 5 years working with Medi-Cal, Medicare and Commercial Lines of Business
• Requires this person to live within 50 miles of the Long Beach, San Diego, or Woodland Hills office locations
• Requires a collaborative team player approach with practical knowledge and proactive leadership and management in the execution of processes and projects within a functional team
• Requires experience working at a health plan (managed care, government payer, or academic)
• Requires technical and functional expertise, business acumen, critical thinking, and decision-making skills
• Requires exceptional written communication skills, including the ability to draft clear, concise executive summaries that articulate negotiation strategy, planning, and execution approaches

Responsibilities

• Lead complex provider negotiations and manage relationships with health systems, hospitals, medical groups, physician organizations, community providers, and ancillary providers serving Promise Health Plan members
• Own negotiations from strategy and financial evaluation through contract language, approval, execution, implementation, and post-contract issue resolution
• Lead cross-functional efforts to advance affordability, network access, product strategy, and sustainable provider partnerships while protecting the company's financial, regulatory, and member interests

Skills

Provider contracting

Negotiation strategy

Medi-Cal/Medicare/Commercial Lines

Education

Bachelor's degree or GED with 4 years of relevant experience

Job description

Blue Shield of California is seeking a senior leader in Government Programs to negotiate provider contracts across commercial, Medi-Cal, and Medicare lines, building accessible, high-quality networks.

You will lead strategy to post-contract issue resolution and cross-functional initiatives to improve affordability and member experience.

Located within 50 miles of Woodland Hills, San Diego, or Long Beach offices, this hybrid role emphasizes leadership development and growth.