Strategic Network Contracts Analyst (Remote-Eligible)

Excellus BlueCross BlueShield; City of Utica (NY); Hybrid; USD 62,000 - 107,000; Full time

Job summary

Excellus BlueCross BlueShield is seeking a professional in network contracting and administration to develop and maintain provider networks. The role involves analyzing provider reimbursement, negotiating contracts, and ensuring regulatory compliance across applicable provider types and regions.

Strong analytical and negotiation skills are essential. The position requires experience in reimbursement methodologies, contract interpretation, and data-driven decision making to support strategic

Qualifications

• Six years of provider network reimbursement or related experience.
• Two years of provider contracting or reimbursement analysis experience.
• Demonstrated experience with 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; collects and interprets data to support contracting activities.
• Effectively prepares and presents information, findings, and recommendations to internal and external stakeholders.
• Serves as liaison with stakeholders; coordinates provider network contract and administration work items.
• Engages in provider contract negotiations with providers and leadership.
• Assist in the preparation of provider contracts, amendments, and communications.
• Maintains knowledge of regulatory mandates to ensure compliance.
• Responds to provider inquiries; leads issue resolution with stakeholders.

Skills

Financial modeling

Contract drafting

Analytical thinking

Verbal and written communication

Regulatory knowledge

Education

Bachelor's degree in Health Care Administration or relevant field

Job description

Excellus BlueCross BlueShield is seeking a professional in network contracting and administration to develop and maintain provider networks. The role involves analyzing provider reimbursement, negotiating contracts, and ensuring regulatory compliance across applicable provider types and regions.

Strong analytical and negotiation skills are essential. The position requires experience in reimbursement methodologies, contract interpretation, and data-driven decision making to support strategic