Manager, Network & Physician Contracting

Horizon is committed to providing innovative healthcare solutions and fostering a culture of collaboration and inclusivity. About the Role The role involves leading and supporting the development, negotiation, management, and maintenance of provider contracts for physician organizations, hospitals, and ancillary facilities across the payment spectrum. Responsibilities Lead/support the development, negotiation, management, and maintenance of provider contracts. Work with the Director on fee-for-service (FFS) and value-based payment contracting initiatives. Collaborate with the payment evolution team to introduce updated payment models. Collaborate with the provider experience team to meet provider expectations. Lead/support complex negotiations and/or contracting arrangements. Develop a sound business strategy for financial and legal terms required for contracting initiatives. Work with Medical Economics and Actuary Department to draft provider rate proposals. Negotiate proposals with hospital executives, physicians, and ancillary providers directly. Manage the development and execution of the network contracting strategy. Adopt value-based contracting for providers operating under fee-for-service models. Minimize special arrangements and align to enterprise affordability objectives. Manage and negotiate contracts in compliance with Horizon reimbursement standards. Assist and implement provider contracting policies and procedures consistent with industry best practices and regulatory requirements. Hospital contracting experience strongly preferred. #J-18808-Ljbffr Horizon Blue Cross Blue Shield of New Jersey