Provider Contracting Specialist, Associate
Blue Shield of CA, Long Beach, California, us, 90899
Your Role
The Network Management team handles provider contracting and provider relations statewide. The Provider Contracting Specialist, Associate, will report to the Sr. Manager of Provider Contracting. This position is responsible for negotiating cost-effective and competitive contracts for a variety of provider types, including Cal AIM Providers. In this role, you will identify, implement, and execute regional strategy initiatives, as well as support of health care strategies, to provide quality and affordable access to our members, and deliver long-term sustainability in the network.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Your Knowledge and Experience
Requires a college degree in Business, Healthcare Policy, Public Health - related field or equivalent experience
Two (2) years of prior relevant experience is preferred
Experience with provider contracting administration, negotiation, and provider relations is strongly preferred
Experience with and or comprehension of Medi-Cal, and Cal AIM, is preferred
Effective project management skills and understanding of contract administration and general healthcare reimbursement methodologies and knowledge of healthcare provider networks
Excellent oral/written, communication and presentation skills, including influence abilities for internal and external discussions
Excellent analytical and problem-solving skills, including knowledge of financial impact analysis
Advanced skill in using software programs, including Microsoft Teams Meeting, Outlook, Word, Excel, PowerPoint
Strong organizational skills, detail-orientation and prioritization, and multi-tasking skills
Thorough knowledge of common organization-specific and other computer application programs
Knowledge of and experience utilizing internet search engines for data gathering purposes
Ability to manage multiple tasks efficiently
Flexible team player who can also work independently
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Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Your Knowledge and Experience
Requires a college degree in Business, Healthcare Policy, Public Health - related field or equivalent experience
Two (2) years of prior relevant experience is preferred
Experience with provider contracting administration, negotiation, and provider relations is strongly preferred
Experience with and or comprehension of Medi-Cal, and Cal AIM, is preferred
Effective project management skills and understanding of contract administration and general healthcare reimbursement methodologies and knowledge of healthcare provider networks
Excellent oral/written, communication and presentation skills, including influence abilities for internal and external discussions
Excellent analytical and problem-solving skills, including knowledge of financial impact analysis
Advanced skill in using software programs, including Microsoft Teams Meeting, Outlook, Word, Excel, PowerPoint
Strong organizational skills, detail-orientation and prioritization, and multi-tasking skills
Thorough knowledge of common organization-specific and other computer application programs
Knowledge of and experience utilizing internet search engines for data gathering purposes
Ability to manage multiple tasks efficiently
Flexible team player who can also work independently
#J-18808-Ljbffr