Principal Provider Contract Analyst
BlueCross BlueShield of North Carolina
**Job Description**
Responsible for leading the assessment, development, articulation, negotiation, implementation and management of the most complex enterprise and divisional innovative provider reimbursement initiatives to be implemented with healthcare providers and integrated healthcare delivery systems. Independently manages contracting with assigned systems to ensure Blue Cross NC holds a leading provider network capability position in the provider network dimension.
**What You'll Do**
+ Responsible for driving comprehensive research, analysis, development, implementation and negotiation of innovative provider network strategies, including:
+ Value based, shared risk arrangements
+ Long-Term Strategic Contracting Initiatives
+ Reducing Cost of Care
+ Improving Quality of Care
+ Product Strategy & Development
+ Provider Incentive Programs
+ Contract Administration Improvements
+ Collaborate and Coordinate with all internal stakeholders to ensure the assignment of resources (FTEs, Technology, etc) necessary to successfully implement the strategic network initiatives.
+ Lead select internal and external (BCBSA, vendors, etc) discussions regarding network strategies to ensure Network Management has direct input into these initiatives, and establish consistency within Blue Cross NC and (where feasible) among other Blues Plans.
+ Accountable for researching, analyzing and negotiating next generation, innovative global provider network opportunities, recommending strategies, gaining Plan approval for select provider strategies, implementing through negotiations those strategies into provider contracts, and ensuring effective use of Plan resources to administer approved strategies.
+ Lead the development of feasibility models and forecasting the performance impact of the innovative contracting strategies.
+ Responsible for direct provider negotiations with key providers, such as academic medical centers and multispecialty professional providers.
+ Connect with Network Management and other internal stakeholders to ensure operational and administrative capabilities are established to implement contract and service strategies
**What You'll Bring (Hiring Requirements)**
+ Bachelor's degree or advanced degree (where required)
+ 8+ years of experience in related field
+ In lieu of degree, 10+ years of experience in related field
**Salary Range**
At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.
_*Based on annual corporate goal achievement and individual performance._
$105,600.00 - $191,800.00
**About Us**
It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians.
Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all.
Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.
**Authorization to Work in the United States**
We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-general-de-e-verify) for Español.
**Request Accommodations**
Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please notify HR at HR.Staffing@bcbsnc.com .
**For most roles, you can choose where to work - fully remote in one of the states listed below, in the office, or a hybrid of the two:**
Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming
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