Strategic Network & Physician Contracting Manager Hybrid

Horizon Blue; New Jersey; Hybrid; USD 109,600 - 149,625; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement plans

Generous PTO

Incentive plans

Wellness programs

Tuition reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a Manager of Network and Physician Contracting to lead development, negotiation, and maintenance of provider contracts across hospital and ancillary facilities. The role collaborates with Medical Economics, Actuary, Legal, and Compliance to ensure regulatory alignment and strategic objectives.

The position requires extensive experience in hospital/provider finance, contract reimbursement methods, and leadership of cross-functional teams.

Qualifications

• High School Diploma/GED required.
• Bachelor degree preferred or relevant experience in health or health care-related field.
• Minimum 5 years demonstrated business experience in hospital and provider group finance and/or managed care network development.
• Minimum 5 years knowledge of contract finance and reimbursement methodologies including FFS, Medicare DRG/APCs, Medicaid pricing, capitation, risk and shared savings.
• Minimum 5 years leading cross-functional teams to achieve improvements.
• Minimum 5 years provider experience in Commercial, Medicare, Medicaid, and Value Based Programs.
• Minimum 3 years health care cost data analysis and technical writing experience.
• Minimum 3 years supervisory experience.

Responsibilities

• Develop and execute network contracting strategy, including value-based contracting for FFS models.
• Negotiate contracts compliant with Horizon reimbursement standards and controls.
• Assist with provider contracting policies aligned with regulatory requirements.
• Load contracts accurately and coordinate with cross-functional teams for network implementation.
• Lead and mentor contracting staff and manage team performance.

Skills

Provider contracting

Negotiation

Team leadership

Healthcare finance

Regulatory knowledge

Contract analytics

Communication

Project management

Cost data analysis

Education

Bachelor's degree

Healthcare experience

Tools

MS Office

Contract management

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a Manager of Network and Physician Contracting to lead development, negotiation, and maintenance of provider contracts across hospital and ancillary facilities. The role collaborates with Medical Economics, Actuary, Legal, and Compliance to ensure regulatory alignment and strategic objectives.

The position requires extensive experience in hospital/provider finance, contract reimbursement methods, and leadership of cross-functional teams.