Senior Provider Network Manager, Provider Contracting

Responsibilities Helps develop unit cost trend targets and specific metric improvement for all providers within the assigned region to continually improve overall competitive position, overseeing an annual spend of at least $300 million and initiatives representing an additional $2M - $10M in annual cost. Acts as the expert go-to person for other team members, ensuring best practices in negotiations to achieve aggressive unit cost and overall health care cost targets, and coaches less experienced network managers to improve their technical expertise. Helps implement department goals under the leadership of the Director of Contracting and ensures alignment of these goals with the company\'s broader strategic priorities. Continuously reviews and modifies contracting strategies in anticipation of, and in response to, shifts in provider and competitor negotiating approaches as well as shifts in product design and/or market opportunities. Improves and maintains highly competitive unit costs across all products and ensures a superior provider network is available to all employer groups. Negotiates independently with minimal guidance from the Director to achieve negotiation results with the most complex providers. Utilizes strong analytical skills and tools to achieve success in negotiation results. Helps implement department goals under the leadership of the Contracting Executives and ensures alignment of these goals with the company\'s broader strategic priorities. Qualifications Demonstrated track record of change leadership including executive influencing skills. Requires broad health care strategy and overall industry knowledge. Superior technical skills in provider contracting strategy, reimbursement methodologies and provider network analysis. Broad business skills including analysis of strategic alternatives, financial impact analysis and sales exposure. Excellent oral and written communication skills. Bachelor\'s degree in Business, Healthcare Policy, Public Health or related field is a must, plus at least 10+ years provider contracting experience at a senior negotiator level or 7+ years with a Master\'s degree. Substantial experience in managing complex and high-profile provider negotiations independently. #J-18808-Ljbffr Blue Shield of California