Provider Contracting Specialist, Senior, Model Contracts

Provider Contracting Specialist, Senior (Model Contracts)

The Model Contracts team manages and maintains Blue Shield of California's standardized provider agreement templates across multiple lines of business and risk arrangements. In this role, the individual will support the accuracy, consistency, and regulatory compliance of provider contract templates, enabling compliant and efficient provider contracting operations across the organization.

Our leadership model is about developing great contributors at all levels and creating opportunities for our people to grow personally, professionally, and financially. We are looking for professionals who are energized by analytical thinking, collaboration, attention to detail, and sustaining high-quality work through continuous improvement.

Responsibilities

In this role, you will:

• Maintain and update standardized provider contract templates used across Blue Shield of California
• Support contract templates covering multiple risk arrangements and product types, including shared, dual, and full risk; facility and medical group agreements; IPPA; and HMO and PPO products
• Coordinate cross-functional reviews of contract template updates with Legal, Mandate teams, and internal subject matter experts
• Incorporate legal, regulatory, and mandate-driven changes into approved template language
• Prepare and manage governmental filings for new or updated provider contract templates and track approval status
• Maintain accurate version control, documentation, and approval records for all model contract templates
• Serve as a resource to Provider Contracting and related teams regarding approved template language and appropriate usage
• Identify potential compliance risks or inconsistencies and escalate through established governance channels
• Support internal audit, compliance, and regulatory review requests related to provider contract templates

Qualifications

Your knowledge and experience:

• Bachelor's degree in Business, Healthcare Administration, Healthcare Policy, Public Health, or a related field, or equivalent experience
• Minimum of 5 years of relevant experience in healthcare contracting, contract administration, regulatory support, or a related role involving standardized agreement maintenance
• Knowledge of healthcare provider contracting concepts and managed care products
• Experience coordinating reviews with legal, regulatory, and business stakeholders
• Strong written and verbal communication skills with high attention to detail
• Strong organizational, prioritization, and documentation skills
• Proficiency with Microsoft Office applications; experience with contract management systems preferred

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.

Blue Shield of California