Strategic Network Contracting Specialist

Horizon Blue Cross Blue Shield of New Jersey; United States; Remote; USD 87,000 - 119,000; Full time

Benefits offered by this job

Comprehensive health benefits (Medical

Dental/Vision

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a seasoned network contracting professional to lead negotiations with a wide network across NJ, PA, and NY. The role focuses on hospitals, physicians and ancillary providers, including value-based programs.

You will collaborate with Medical Economics, Actuary, and Legal to prepare rate proposals, ensure contracts meet regulatory standards, and drive affordability and strategic objectives.

Qualifications

• Requires minimum 5 years in hospital finance or managed care network development.
• Experience in two or more with contract finance and reimbursement methodologies (FFS, DRG, APCs).
• Experience with Commercial, Medicare, Medicaid, and Value Based Programs.

Responsibilities

• Facilitate and lead network provider negotiations for Horizon’s lines of business.
• Ensure accurate implementation of contracts and loadings across systems.
• Collaborate with Legal and Compliance to modify provider templates for regulatory alignment.
• Develop and implement network contracting policies and procedures.
• Coordinate across departments to align provider services with member needs.

Skills

Negotiation

Stakeholder management

Analytical skills

Communication skills

Education

Bachelor's degree in business/finance/health admin

Master’s degree preferred

Tools

MS Office

Contract management systems

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a seasoned network contracting professional to lead negotiations with a wide network across NJ, PA, and NY. The role focuses on hospitals, physicians and ancillary providers, including value-based programs.

You will collaborate with Medical Economics, Actuary, and Legal to prepare rate proposals, ensure contracts meet regulatory standards, and drive affordability and strategic objectives.