Provider Contracts Manager

To change the future of health care in California, Blue Shield needs people who believe in the possibilities and are willing to work to make them real. Is this you?

Manages team of Contracting Managers and support staff engaged in the development, negotiation, implementation and maintenance of comprehensive provider and/or hospital networks.

Manages the provider and hospital network development process in an assigned region; implements network contract strategies and identifies potential network participants.

Initiates contact with non-participating providers and hospitals and establishes positive relationships within the community to develop interest in participating in Blue Shield programs.

Provides developmental and training opportunities for team members; monitors on-going performance; communicates expectations and results on a regular basis; communicates and interprets changes in guidelines, policies, procedures and other related matters.

Provides technical support and guidance to less experience team members. Oversees research activities and evaluates findings. Resolves complex issues and problems as needed.

Prepares and submits reports and recommendations for management review. Prepares and submits summaries and reports to external agencies and organizations as required.

Develops and evaluates effectiveness of programs used to educate, counsel and instruct provider community to comply with managed care requirements.

Where necessary, directs negotiations with providers, medical groups, IPAs and hospitals; manages development of complex legal documents detailing complicated financial arrangements, payments and risk provisions.

Blue Shield of California is an Equal Opportunity Employer.

Bachelor's degree and seven years of relevant experience or equivalent combination of education and experience.

Thorough knowledge of the health care industry, managed care delivery systems, provider service network development, management and administration; strong negotiating skills.

Demonstrated leadership, program evaluation and communication skills and ability to interact with all levels including senior management and influence decision-making.