Hybrid Provider Contracting Manager

at Blue Cross and Blue Shield of Nebraska

• Job title: Provider Contracting Manager
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, United States

About the role

• Provider Contracting Manager at BCBSNE handling provider agreements and negotiations. Collaborating with legal teams and ensuring successful provider relationships for commercial and Medicare programs.

Responsibilities

• 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

Requirements

• 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

Benefits

• Health and well-being support for members and communities
• Opportunities to build a meaningful career