About this role

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

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

Provider Contracting Manager

Key skills