Strategic Network Contracting Analyst

Excellus BCBS; City of Binghamton (NY); Hybrid; USD 62,000 - 107,000; Full time

Benefits offered by this job

Remote work option

Health and dental insurance

Retirement plan

Job summary

Excellus BCBS in New York state seeks a seasoned professional to develop and maintain provider networks. The role involves provider and network analysis, evaluating reimbursement, and negotiating contracts in line with corporate strategy.

You will apply knowledge of regulatory requirements, pricing methodologies, and market trends to support network contracting and administration across business lines.

Qualifications

• Six (6) years of provider network reimbursement or related experience.
• Two (2) years of experience directly performing provider contracting or reimbursement analysis.
• Demonstrated experience of provider reimbursement methodologies.
• Ability to draft, interpret and apply contractual language.
• Technical skills including modeling and financial analysis.
• Understanding of medical care delivery, industry trends, and regional market dynamics.
• Strong, persuasive, and effective verbal and written communication skills.

Responsibilities

• Establishes and maintains network adequacy for assigned provider types, regions and/or lines of business.
• Analyzes, develops, and proposes formal provider reimbursement recommendations within approved budgets and according to health plan strategies.
• Identifies, investigates, and analyzes issues and questions. Collects and interprets data to support provider network contracting activities.
• Effectively prepares and presents information, findings, and recommendations to stakeholders.
• Engages in provider contract negotiations and works with providers, clinical, and operational leadership.

Education

Bachelor’s degree in Health Care Administration or relevant field

Job description

Excellus BCBS in New York state seeks a seasoned professional to develop and maintain provider networks. The role involves provider and network analysis, evaluating reimbursement, and negotiating contracts in line with corporate strategy.

You will apply knowledge of regulatory requirements, pricing methodologies, and market trends to support network contracting and administration across business lines.