Provider Contracting Leader

Today's healthcare industry -- dynamic and changing at a fast pace. Recruiting talented people can mean the difference between success or failure. At Blue Cross and Blue Shield of Massachusetts, our record of achievement represents a history of hiring the best people we can find, and then challenging them to excel. It's the kind of environment that enables us to give our best to the consumers we serve, and at the same time, work to the potential of those who work for us.

Provider Contracting Leader

Blue Cross Blue Shield of Massachusetts is an Equal Opportunity Employment/Affirmative Action Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, or any other characteristics protected by law.

Major Responsibilities

Develop and negotiate new and innovative contracting approaches and methodologies for physician and institutional providers for all products which maximize BCBSMA competitive position

Minimize risk to the company, and meet or exceed financial goals.

Lead contract presentations and negotiations with Network Development leadership.

Co-lead strategic planning(with NDM) in the development of business plans for regional teams.

Facilitate collaboratively the development of new provider strategies, reimbursements methods, networks and approaches. Ensure the implementation of new contracting initiatives.

Develop and utilize management reporting mechanisms tracking the status of all contracting projects under your direction. Encourage change innovation, risk taking in the following areas: contract negotiation, alliance building, strategic partnerships.

Negotiate complex risk sharing and financial arrangements with RSO's and Hospitals, ensuring that both the business and financial objectives are achieved in all initiatives.

Develop and write financial and non-financial provisions of provider contracts and direct required financial analyses to support negotiations

Lead cross functional negotiation teams

Qualifications

Solid understanding of: Provider Contract Development; demonstrated negotiations of risk deals with significant impact and; demonstrated strength in finance to support financial arrangements and analysis; risk arrangements and health care reimbursement methods and strategies; legal experience a plus.

Demonstrated ability to influence, negotiate, and operate collaboratively in a team partnership environment.

Solid written/verbal communications skills; effective presentation skills; project management and planning critical.


BA/BS Required; Masters Preferred

3-5 years demonstrated provider contracting and/or health care finance

demonstrated financial analysis and modeling

solid negotiations experience

strategic thinker; ability to effectively influence and interact effectively at all levels

team builder