Provider Contracting Specialist, Consultant

Your Role

The Network Management team handles provider contracting and provider relations statewide. The Provider Contracting Specialist, Consultant will report to the Senior Manager of Provider Contracting. In this role you will support Medical Group/IPA and Hospital/Facility contracting in Southern California for all Blue Shield products. You will be responsible for comprehensive management of Medical Group/IPA and Hospital/Facility provider network contract processes including derivation, implementation, and ongoing support of assigned provider agreements. You will support contracting initiatives to drive department objectives to achieve timely contract negotiations and implementation that support growth and maintain strong market position and positive reputation in the market.

Your Knowledge and Experience

• Requires a bachelor's degree in business, healthcare policy, public health or related field, or equivalent experience
• Requires at least 7 years provider contracting / negotiation experience including experience managing complex negotiations
• Excellent oral/written, communication and presentation skills, including influence abilities for internal and external discussions
• Effective project management skills and understanding of contract administration and general healthcare reimbursement methodologies and knowledge of healthcare provider networks
• Excellent analytical and problem-solving skills, including knowledge of financial impact analysis
• Experienced in Microsoft Office including, Word, Excel, PowerPoint, and Outlook. Experience working with a contract management system preferred
• Strong organizational skills, detail-orientation and prioritization, and multi-tasking. Flexible with ability to manage multiple tasks efficiently
• Flexible team player who can also work independently