Strategic Provider Contracting Specialist (Hybrid)

Blue Shield of CA; Oakland (CA); Hybrid; USD 120,000 - 180,000; Full time

Job summary

Blue Shield of California is seeking a Provider Contracting Specialist, Consultant to manage a portfolio of provider negotiations and contracting initiatives across California. You will execute complex negotiations from strategic analysis through implementation, ensuring alignment with statewide contracting strategies and governance.

In this hybrid role, you will collaborate across functions to improve affordability, network access, and business objectives, while meeting policies, controls, and

Qualifications

• Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree required.
• 7 years of prior relevant experience
• Previous experience with provider contracting and negotiation experience
• Advanced working knowledge of provider contracting, reimbursement methodologies, provider contract language
• Working knowledge of managed care operations and the implications of provider agreements
• Demonstrated ability to interpret data, evaluate alternatives, develop negotiation strategies

Skills

Provider contracting

Negotiation strategy

Data interpretation

Portfolio management

Managed care operations

Contract language knowledge

Reimbursement methodologies

Education

Bachelor's degree or HS diploma plus 4 years' relevant experience

Job description

Blue Shield of California is seeking a Provider Contracting Specialist, Consultant to manage a portfolio of provider negotiations and contracting initiatives across California. You will execute complex negotiations from strategic analysis through implementation, ensuring alignment with statewide contracting strategies and governance.

In this hybrid role, you will collaborate across functions to improve affordability, network access, and business objectives, while meeting policies, controls, and