Principal Provider Contract Analyst

Job Description

Responsible for leading the assessment, development, articulation, negotiation, implementation and management of the most complex enterprise and divisional innovative provider reimbursement initiatives to be implemented with healthcare providers and integrated healthcare delivery systems. Independently manages contracting with assigned systems to ensure Blue Cross NC holds a leading provider network capability position in the provider network dimension.

What You'll Do

• Responsible for driving  comprehensive research, analysis, development, implementation and negotiation of innovative provider network strategies, including:
  • Value based, shared risk arrangements
  • Long-Term Strategic Contracting Initiatives
  • Reducing Cost of Care
  • Improving Quality of Care
  • Product Strategy & Development
  • Provider Incentive Programs
  • Contract Administration Improvements

• Collaborate and Coordinate with all internal stakeholders to ensure the assignment of resources (FTEs, Technology, etc) necessary to successfully implement the strategic network initiatives.
• Lead select internal and external (BCBSA, vendors, etc) discussions regarding network strategies to ensure Network Management has direct input into these initiatives, and establish consistency within Blue Cross NC and (where feasible) among other Blues Plans.
• Accountable for researching, analyzing and negotiating next generation, innovative global provider network opportunities, recommending strategies, gaining Plan approval for select provider strategies, implementing through negotiations those strategies into provider contracts, and ensuring effective use of Plan resources to administer approved strategies.
• Lead the development of feasibility models and forecasting the performance impact of the innovative contracting strategies.
• Responsible for direct provider negotiations with key providers, such as academic medical centers and multispecialty professional providers.
• Connect with Network Management and other internal stakeholders to ensure operational and administrative capabilities are established to implement contract and service strategies

What You'll Bring (Hiring Requirements)

• Bachelor's degree or advanced degree (where required)
• 8 years of experience in related field
• In lieu of degree, 10 years of experience in related field

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets,  licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. 

*Based on annual corporate goal achievement and individual performance.
 

$105,600.00 - $191,800.00

Salary : $105,600 - $191,800