Principal Provider Contracting

Are you driven by a passion for enhancing healthcare delivery and building impactful partnerships? BlueCross BlueShield of Tennessee’s Provider Networks & Contracting department is looking for a dynamic and detail-oriented Principal to join our mission of improving healthcare access and affordability. In this role, you will utilize your expertise in contract negotiations, relationship management, and healthcare economics to establish and maintain effective agreements with some of the largest and most prominent healthcare providers in the state. If you are a strategic thinker with exceptional analytical skills and a desire to innovate, we want to hear from you. Help us shape the future of healthcare and make a meaningful difference in the lives of our members.

You’ll be a great match for this role if, in addition to the above, you can demonstrate strong skills in public speaking and leadership, as this role manages a team of service-focused Network Managers.

This role will require occasional face-to-face provider meetings and in-person staff meetings in the Nashville, TN, area

Job Responsibilities

• Influences and executes multi-year network strategies, contract renewals and leadership support, influencing overall reimbursement strategies, mitigating unfavorable pricing impacts, addressing relationship challenges/opportunities and other using relevant market intelligence that informs and drives network strategies.
• Establishes processes and practices for contract negotiation and /or provider issue resolution; administering existing contracts and renewing strategic alliances.
• Interacts and works closely with all relevant areas within the organization to ensure provider contract strategies are supported and consistent with organizational business goals and regulations.
• Directs and/or participates in provider issue resolution and provider education across lines of business.
• Able to travel to provider offices or conduct virtual meetings as required.

Job Qualifications

Education

• Bachelor’s Degree or equivalent work experience required.

Experience

• 5 years in Managed Care or equivalent with focus on health care contracting and/or network management experience. Specific to Behavioral Health direct experience with commercial and/or government insurance programs or direct experience with behavioral health provider/community-based programs.

Skills\Certifications

• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles, and accountability.
• Demonstrated knowledge and experience with a wide range of provider contracting arrangements, value-based reimbursement strategies and provider reimbursement methodologies.
• Proficient in Microsoft Office
• Direct experience in managing provider projects
• Excellent oral and written communication skills
• Strong interpersonal and organizational skills

BBEX 13 T60215 – EX/CAP Grd 13