Contract Manager, Principal

Company: Blue Shield of California
Location: Rancho Cordova
Posted on: November 18, 2021

Job Description:

Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience. To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen. Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in - join us! Job Summary Contract Manager (Provider Contracting Specialist - internal job title) - Prepares, analyzes, reviews, and projects financial impact of large or complex provider contracts and alternate contract terms. Conducts negotiations and drafts individual contracts. Ensures the smooth operation and administration of provider agreements. Focus on either 1) medical groups/IPA's, hospitals, Skilled Nursing Facilities and freestanding surgery centers, or 2) PPO and Specialty Benefits. In addition, supports Regional Strategy. Responsibilities * Oversees an annual spend of nearly $80M - $400M. * Participates in cross-functional team to implement initiatives to help manage the total cost of health care across the assigned region * Collaborates closely with * Medical Management, * Provider Relations, Network Analytics and Sales to meet aggressive regional goals. * Drives alignment with Pricing, Underwriting and sales regarding unit cost and other contracting activities. * Identifies strategic opportunities within local market (i.e., network expansion opportunities, utilization or unit cost excesses, etc.). * Assesses market trends and competitive benchmarks to enhance company's market position. * Other duties as assigned. Knowledge and Experience * 7-10 years provider contracting experience with a Bachelors degree in Business, Healthcare Policy, Public Health or related field or 6 years and a Master's degree; or a PhD with 3 years of experience. * Substantial experience in managing complex and high-profile provider negotiations. * Requires mastery level knowledge of job area typically obtained through advanced education combined with experience. 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 be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes * Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals Additional Information * About Company: At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We--------re excited to share Blue Shield of California has received awards and recognition for -----" LGBT diversity, quality improvement, most influential women in corporate America, Bay Area--------s top companies in volunteering & giving, and one of the world--------s most ethical companies. Here at Blue Shield of California, we--------re striving to make a positive change across our industry and the communities we live in -----" Join us! * 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. * EEO Footer: 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. * Requisition ID: 21001ZL * Posting Date: Oct 29, 2021 * Schedule: Full-time

Keywords: Blue Shield of California, Rancho Cordova , Contract Manager, Principal, Executive , Rancho Cordova, California