Strategic Network Contracting Specialist

Horizon Blue Cross Blue Shield; Newark (NJ); Hybrid; USD 87,000 - 119,000; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey seeks a network contracting professional to lead negotiations with provider partners across Commercial, Medicare, Medicaid, DSNP, and other lines. You will ensure contracts are loaded accurately and support rate proposals aligned with Horizon’s budgeting standards.

You will collaborate with Legal, Compliance and Finance, drive value‑based contracting initiatives, and develop policies to ensure compliant, cost-effective agreements for members and the

Qualifications

• Requires a bachelor’s degree with relevant experience in hospital finance or managed care.
• Master’s degree preferred; strong understanding of contract finance and reimbursement methods.
• Minimum five years of provider experience across Commercial, Medicare, Medicaid, and Value Based Programs.

Responsibilities

• Lead network provider negotiations for Horizon's lines of business.
• Ensure accurate contract implementation and loading across departments.
• Coordinate provider file maintenance, claims stops, and new hospital implementations.
• Collaborate with Medical Economics, Actuary, Legal and Compliance on rate proposals.
• Develop and maintain provider contracting policies aligned with regulatory requirements.

Skills

Negotiation skills

Analytical skills

Communication skills

Problem-solving

Detail-oriented

Team collaboration

Education

Bachelor degree in business, finance, accounting, health administration

Master’s degree in health or business

Tools

MS Office (Word, Excel, PowerPoint)

Job description

Horizon Blue Cross Blue Shield of New Jersey seeks a network contracting professional to lead negotiations with provider partners across Commercial, Medicare, Medicaid, DSNP, and other lines. You will ensure contracts are loaded accurately and support rate proposals aligned with Horizon’s budgeting standards.

You will collaborate with Legal, Compliance and Finance, drive value‑based contracting initiatives, and develop policies to ensure compliant, cost-effective agreements for members and the