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BN
Hybrid Provider Contracting Manager
Posted last month
About the role
- Provider Contracting Manager at BCBSNE handling provider agreements and negotiations. Collaborating with legal teams and ensuring successful provider relationships for commercial and Medicare programs.
Responsibilities
- Responsible for physician, hospital, and ancillary provider contracting for BCBSNE Commercial and Medicare Advantage Network
- Pursuit of executed contracts with health care providers
- Participation in the strategic administration of the provider networks and related reimbursement of participating providers
- Negotiate all language and payment terms with providers for both commercial and Medicare business
- Responsible for negotiating and executing case specific out-of-network exceptions for BCBSNE members
- Work with the Legal Department in resolving contractual questions and issues posed by participating network providers
- Assist department leadership in strategic planning and resolving issues during key provider negotiations
- Collaborate with cross functional teams to ensure consistency and strategy in practice
Requirements
- Bachelor’s degree in Business, Health Care, or a related field
- Three (3) years of provider contracting and/or provider network administration experience
- An equivalent combination of education and experience may be substituted for this requirement
- The ability to meet or exceed the attendance and timeliness requirements of their departments
- The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers
Benefits
- Health and well-being support for members and communities
- Opportunities to build a meaningful career
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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