Sr. Manager, Provider Contracting

Your Role

The Model Contracts team is responsible for the development and management of provider contract templates and related language that support the Blue Shield of California and Blue Shield of California Promise Health Plan networks across all lines of business. The Sr. Manager, Model Contracts will report to the Director, Network Operations. In this role you will be responsible for developing, maintaining, and optimizing standardized contract templates, exhibits, amendments, and related documentation used in provider and managed care contracting. This role partners closely with Legal, Network Management, Contracting, Finance, Compliance, Operations, and other stakeholders to ensure templates are clear, accurate, compliant, operationally usable, and aligned with business objectives. In addition, the Sr. Manager, Model Contracts will manage the Model Contracts team inclusive of Contract Specialists.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

We are actively recruiting candidates within 50 miles of our BSC offices in Woodland Hills, Long Beach, and San Diego ONLY.

Responsibilities

Your Work

In this role, you will:

• Lead the designing, drafting, and updating of standardized contract templates, schedules, exhibits, amendments, notices, and other contracting documents for provider network agreements.
• Manage the continuous review and modification of 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
• Translate business, legal, regulatory, reimbursement, and operational requirements into practical template language that supports consistent contract execution and administration.
• Partner with Legal and Compliance to ensure templates reflect applicable laws, regulations, delegation requirements, plan policies, accreditation standards, and internal governance expectations.
• Develop intake models, clause playbooks, training materials, and process documentation to ensure Contracting teams apply appropriate templates consistently and timely.
• Collaborate with Network Strategy and cross-functional teams related to new products, provider network strategies, reimbursement models, value-based arrangements, regulatory changes, and system implementations.
• Support initiatives to improve and maintain highly competitive unit costs across all products to ensure that a superior provider network is available to all Blue Shield and Blue Shield Promise Health Plan members.
• Lead the Model Contracts team by managing, hiring, training, and directing the Model Contracts Contracting Specialists to function as a high-performing team
• Collaborate with Network Management, Provider Contracting, Finance, Operations, Claims, Credentialing, and Provider Data teams to ensure template provisions can be implemented accurately across downstream systems and processes.
• Maintain a centralized template library, including version control, approved clauses, and drafting guidance.
• Support contract standardization initiatives by identifying opportunities to simplify language, reduce variation, improve usability, and strengthen operational consistency.
• Review stakeholder feedback, contract exceptions, recurring negotiation issues, and operational pain points to recommend template enhancements.

Qualifications

Your Knowledge and Experience

• Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree

• Advanced degree preferred (JD, MBA, MPH, MHA)

• Requires at least 8 years of experience in health plan operations, provider contracting, network management, or related fields

• Requires 4 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports

• Requires extensive knowledge and expertise in managed healthcare in the California market including risk models, payment methodologies, regulatory compliance and end-to-end health plan operations

• Requires excellent writing, editing, proofreading, and document organization skills, with the ability to convert complex requirements into clear and consistent contract language.

• Requires excellent written and verbal communication skills with a proven track record in effective relationship building and influencing stakeholders at all levels of the organization
• Strong attention to detail, analytical thinking, judgment, and ability to manage multiple priorities in a deadline-driven environment.
• Ability to collaborate effectively with legal, business, operational, technical, and leadership stakeholders.

• Proficiency with Microsoft Word, document management tools, version control practices, and contract lifecycle or workflow systems.

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
• Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.

• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.

• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.