Strategic Provider Contracting Lead (CA)

Blue Shield of CA; San Diego (CA); Hybride; USD 110 000 - 140 000; Plein temps

Résumé du poste

Blue Shield of CA in California seeks a Provider Contracting Specialist, Consultant to independently manage complex provider negotiations and contracting initiatives. You will drive strategic analysis through execution within statewide contracting strategies and governance, delivering outcomes aligned with affordability and network access.

You will partner across the organization, ensuring timely execution, risk identification, and escalation when broader policy or executive decisions are

Qualifications

• Bachelor's degree or equivalent with 4 years of relevant experience.
• 7 years of prior relevant experience in provider contracting and negotiation.
• Advanced knowledge of provider contracting, reimbursement methodologies, contract language.
• Working knowledge of managed care operations and regulatory implications of provider agreements.
• Ability to interpret data, evaluate options, and translate analysis into recommendations.
• Strong project and portfolio-management skills to handle multiple negotiations and milestones.

Responsabilités

• Lead and manage an assigned portfolio of provider negotiations and contracting initiatives.
• Execute negotiations from strategic analysis through execution and issue resolution.
• Partner across the organization to advance affordability, network access, and business objectives.
• Ensure work adheres to established contracting strategies, policies, controls, and approvals.
• Proactively identify risks and escalate matters requiring broader policy or executive input.

Connaissances

Provider contracting

Negotiation

Data analysis

Portfolio management

Financial analysis

Formation

Bachelor's degree or equivalent with 4 years of relevant experience

Description du poste

Blue Shield of CA in California seeks a Provider Contracting Specialist, Consultant to independently manage complex provider negotiations and contracting initiatives. You will drive strategic analysis through execution within statewide contracting strategies and governance, delivering outcomes aligned with affordability and network access.

You will partner across the organization, ensuring timely execution, risk identification, and escalation when broader policy or executive decisions are