Senior Provider Relations & Network Solutions Lead

Blue Shield of CA; Springfield Meadows (CA); Hybrid; USD 95.000 - 125.000; Vollzeit

Zusammenfassung

Blue Shield of California is seeking a Senior Provider Relations Representative to build and sustain strong relationships with the provider network, ensuring contract compliance and effective issue resolution across operations.

The role requires navigating complex payer relationships, coordinating with internal teams, and guiding initiatives to meet network goals while fostering professional growth in a hybrid in-office model.

Qualifikationen

• Requires a bachelor’s degree or High School/GED with 4 years of relevant experience.
• Requires 5 years of prior relevant experience.
• Experience working at a health plan (managed care, government payer, or academic) preferred.
• Experience working directly with CA provider networks.

Aufgaben

• Build and maintain provider relationships to support network goals.
• Ensure contract compliance and alignment with network requirements.
• Partner with providers and internal teams to resolve operational issues.
• Demonstrate leadership by guiding teams and driving continual improvement.

Kenntnisse

Relationship management

Time management

Presentation skills

Multi-tasking

Regulatory knowledge

Ausbildung

Bachelor's degree

High School/GED + 4 years experience

Jobbeschreibung

Blue Shield of California is seeking a Senior Provider Relations Representative to build and sustain strong relationships with the provider network, ensuring contract compliance and effective issue resolution across operations.

The role requires navigating complex payer relationships, coordinating with internal teams, and guiding initiatives to meet network goals while fostering professional growth in a hybrid in-office model.