Strategic Provider Contracting Specialist (Hybrid)

Blue Shield of CA; Springfield Meadows (CA); Hybride; USD 120 000 - 180 000; Plein temps

Résumé du poste

Blue Shield of CA is seeking a Provider Contracting Specialist, Consultant to lead negotiations and contracting initiatives across California. You will independently manage complex provider negotiations, analyze financial and strategic implications, and drive execution within established contracting strategies and controls.

You will collaborate with stakeholders to improve affordability and network access while ensuring alignment with policies, resources, and escalation protocols.

Qualifications

• Bachelor's degree or HS Diploma/GED with 4 years of related experience required.
• 7 years of prior relevant experience; 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.

Responsabilités

• Independently manage a portfolio of provider negotiations and contracting initiatives.
• Analyze strategic and financial aspects from analysis through execution and issue resolution.
• Partner across the organization to advance affordability, network access, and business objectives.
• Identify risks and escalate matters requiring broader policy, resource, or executive decisions.

Connaissances

Negotiation

Data interpretation

Portfolio management

Project management

Financial analysis

Provider contracting

Formation

Bachelor's degree or HS Diploma/GED with 4 years' related experience

Description du poste

Blue Shield of CA is seeking a Provider Contracting Specialist, Consultant to lead negotiations and contracting initiatives across California. You will independently manage complex provider negotiations, analyze financial and strategic implications, and drive execution within established contracting strategies and controls.

You will collaborate with stakeholders to improve affordability and network access while ensuring alignment with policies, resources, and escalation protocols.