Sr Provider Contract Analyst

Blue Cross and Blue Shield of North Carolina; North Carolina; Hybrid; USD 89,000 - 143,000; Full time

Benefits offered by this job

Health benefits

Parental leave

Tuition assistance

401k match

Job summary

Blue Cross and Blue Shield of North Carolina is seeking a Senior Provider Contract Analyst to lead assessment, development, articulation, negotiation and management of innovative provider reimbursement initiatives. You will manage contracting with systems to maintain a leading provider network position and collaborate with internal stakeholders across the enterprise.

The role requires a bachelor’s or advanced degree with 5+ years in related fields (or 7+ years without a degree).

Qualifications

• Bachelor's degree or advanced degree required; 5+ years of experience in related field.
• In lieu of degree, 7+ years of experience in related field.

Responsibilities

• Conduct research, analysis, development, implementation and negotiation of provider network strategies including value-based and risk-sharing arrangements.
• Negotiate and implement innovative contracting initiatives with academic medical centers and multispecialty providers.
• Coordinate with internal stakeholders to allocate resources and ensure successful deployment of network strategies.
• Develop feasibility models and forecast performance impacts of contracting strategies.
• Participate in direct provider negotiations and ensure operational capabilities support contract execution.

Skills

Complex Project Management

Contracting Strategies

Contract Management

Contract Negotiations

Health Care

Healthcare Contracts

Healthcare Networks

Health Care Quality Improvement

Network Development

People Management

Project Management

Provider Contracts

Provider Network Management

Resource Allocation

Resource Management

Vendor Relationships

Education

Bachelor's degree or advanced degree

Job description

Job Description

We're hiring a Senior Provider Contract Analyst who will be responsible for the assessment, development, articulation, negotiation, implementation and management of complex enterprise and divisional innovative provider reimbursement initiatives to be implemented with healthcare providers and integrated healthcare delivery systems. You will also manage contracting with assigned systems to ensure Blue Cross NC holds a leading provider network capability position in the provider network dimension.

What You'll Do

Responsible for research, analysis, development, implementation and negotiation of innovative provider network strategies, including: Value based, shared risk arrangements Long-Term Strategic Contracting Initiatives Reducing Cost of Care Improving Quality of Care Provider Incentive Programs Contract Administration Improvements Coordinate with all internal stakeholders to ensure the assignment of resources (FTEs, Technology, etc.) necessary to successfully implement the strategic network initiatives. Provide expertise in select internal and external (BCBSA, vendors, etc.) discussions regarding network strategies to ensure Network Management has direct input into these initiatives, and establish consistency within Blue Cross NC and (where feasible) among other Blues Plans. Accountable for facilitating next generation, innovative global provider network opportunities, recommending strategies, gaining Plan approval for select provider strategies, implementing through negotiations those strategies into provider contracts, and ensuring effective use of Plan resources to administer approved strategies. Contribute to the development of feasibility models and forecasting the performance impact of the innovative contracting strategies. Participate in direct provider negotiations with key providers, such as academic medical centers and multispecialty professional providers. Connect with Network Management and other internal stakeholders to ensure operational and administrative capabilities are established to implement contract and service strategies.

What You Bring

• Bachelor's degree or advanced degree (where required) 5+ years of experience in related field.
• In lieu of degree, 7+ years of experience in related field.

What You'll Get

• The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community
• Work-life balance, flexibility, and the autonomy to do great work
• Medical, dental, and vision coverage along with numerous health and wellness programs
• Parental leave and support plus adoption and surrogacy assistance
• Career development programs and tuition reimbursement for continued education
• 401k match including an annual company contribution
• Learn more

Where You'll Work

Our Hybrid-Flex approach is built on presence with a purpose - giving you flexibility to work remotely with intentional in-person connection - that supports a workplace that's flexible, connected, and future focused. In a Hybrid-Flex role, you'll work in the office at least two days a week for collaboration and connection. In a Remote-Flex role, you'll work virtually, with a few in-office visits each year for meaningful moments that matter. Whether your role is Hybrid-Flex or Remote-Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $89,174.00 - $142,679.00

Skills

• Complex Project Management
• Contracting Strategies
• Contract Management
• Contract Negotiations
• Health Care
• Healthcare Contracts
• Healthcare Networks
• Health Care Quality Improvement
• Network Development
• People Management
• Project Management
• Provider Contracts
• Provider Network Management
• Resource Allocation
• Resource Management
• Vendor Relationships

About Us

It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care - in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians. Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all. Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.

Authorization to Work in the United States

We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview for English or Visión General de E-Verify for Español.

Request Accommodations

Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application, hiring process, or have technical issues that prevent you from completing your application please notify HR at [e-mail]. Blue Cross NC is a Hybrid Flex company. Whether the role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any of our approved states: Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming