What are the responsibilities and job description for the Manager, Provider Contracting position at Blue Cross of Idaho?
Blue Cross of Idaho is seeking a Manager, Provider Contracting who will be responsible for the management, operation, direction, organization, and administration of provider contracts and team members. This person will ensure that the provider contracts optimize strategic opportunities leading to cost effective healthcare for our members.
This position reports to the Director, Provider Network Management
We are looking for a candidate with:
Experience: 7 years’ provider contract/network management, provider reimbursement methodologies, contracting, negotiation, or relevant experience
Education: Bachelor’s Degree or equivalent work experience (Two years’ relevant work experience is equivalent to one-year college)
What a day of a Manager would look like:
- Guides and coaches’ staff in contract negotiation processes.
- Manages relationships with providers and internal business partners.
- Develops and maintains cost-effective network of contracted providers.
- Trains, and mentors contracting staff in the management and implementation of contracts and the performance of these agreements.
- Ensures effective workflows and maximizes system efficiencies. Makes recommendations for changes.
- Leads complex contract implementation projects.
- Creates innovative payment methodologies that align the incentives of healthcare providers with outcomes based, cost effective healthcare.
- Identifies strategic opportunities for standard and/or complex contracts to increase cost savings and monitors successful financial performance.
- Manages, formulates, analyzes, coordinates, and negotiates contracts with professional and ancillary providers
- Manages contracting process, contract negotiations, execution, and implementation of contract and payment methodologies.
- Improves provider network efficiencies through the identification of cost and quality outliers.
- Performs other duties and responsibilities as assigned.
Reasonable accommodations
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
