Strategic Provider Contracting Leader (Hybrid)

Blue Shield of CA; Rancho Cordova (CA); Hybrid; USD 90,000 - 150,000; Full time

Job summary

Blue Shield of California is seeking a Provider Contracting Specialist, Consultant to independently manage complex provider negotiations and contracting initiatives across the state's networks. You will analyze financials, translate data into strategic recommendations, and ensure execution within governance and contracting policies.

In-office hybrid role, two days per week, with flexibility for business needs.

Qualifications

• Bachelor's degree or High School Diploma/GED with 4 years of additional relevant experience in lieu of a degree required.
• 7 years of prior relevant experience required; provider contracting and negotiation experience preferred.
• Advanced working knowledge of provider contracting, reimbursement methodologies, provider contract language, financial impact analysis, and provider network management preferred.
• Working knowledge of managed care operations and the financial, operational, legal, regulatory, and member implications of provider agreements preferred.
• Demonstrated ability to interpret data, evaluate alternatives, develop negotiation strategies, and translate analysis into practical recommendations preferred.
• Strong project and portfolio-management skills, including the ability to manage multiple negotiations, milestones, dependencies, and competing priorities preferred.

Responsibilities

• Execute an assigned portfolio of provider negotiations and contracting initiatives within statewide strategies and governance.
• Manage complex negotiations from strategic and financial analysis through execution and issue resolution.
• Partner across the organization to advance affordability, network access, and business objectives while following contracting policies.
• Identify risks and escalate matters requiring broader policy, resource, or executive decisions.

Skills

Provider contracting

Negotiation experience

Financial impact analysis

Data interpretation

Portfolio management

Education

Bachelor's degree or High School Diploma/GED with 4 years of relevant experience in lieu of a degree

Job description

Blue Shield of California is seeking a Provider Contracting Specialist, Consultant to independently manage complex provider negotiations and contracting initiatives across the state's networks. You will analyze financials, translate data into strategic recommendations, and ensure execution within governance and contracting policies.

In-office hybrid role, two days per week, with flexibility for business needs.