Principal Provider Contract Analyst

Blue Cross and Blue Shield of North Carolina•Remote Flex - North Carolina, NC

1d•$118,691 - $189,906•Hybrid

About The Position

This position serves as the provider account executive and central point of coordination between Blue Cross NC and its largest and most strategically important healthcare delivery systems and provider organizations. The incumbent builds trusted executive partnerships, leads complex negotiations, resolves escalated provider issues, and influences strategic initiatives that advance organizational priorities. The role oversees the end-to-end provider contracting lifecycle, including network strategy, reimbursement innovation, provider engagement, contract negotiation and implementation, performance management, and compliance oversight. As a strategic advisor and subject-matter expert, the Principal Provider Contract Analyst leads cross-functional initiatives that support value-based care, improve affordability and quality outcomes, strengthen provider partnerships, and enhance Blue Cross NC’s competitive position. Limited travel is required within North Carolina, and candidates must live in North Carolina. Onsite expectations will be discussed during the interview process. The role follows a Hybrid-Flex or Remote-Flex approach depending on the work and distance from the Durham headquarters. Hybrid-Flex roles require working in the office at least two days a week; Remote-Flex roles require a few in-office visits each year.

Requirements

Bachelor’s degree or advanced degree where required; in lieu of a degree, 10+ years of experience in a related field.
8+ years of experience in a related field.
Candidates must live in North Carolina.
Limited travel within North Carolina is required.

Nice To Haves

Experience in healthcare provider contracting, network management, provider relations, or managed care, including accountability for large health systems and strategically significant provider organizations.
Demonstrated success leading complex provider contract negotiations, including value-based care arrangements, risk-sharing models, alternative payment methodologies, and reimbursement innovation.
Ability to build and maintain executive-level relationships with health system executives, physician leaders, and other senior healthcare stakeholders.
Experience leading cross-functional strategic initiatives involving network strategy, finance, actuarial, clinical, operations, legal, and product teams.
Strong financial and analytical acumen, including provider economics, contract modeling, forecasting, performance analysis, and cost-of-care management.
Knowledge of healthcare reimbursement methodologies, value-based care principles, regulatory requirements, and healthcare market dynamics, and ability to translate insights into actionable business strategies.

Responsibilities

Manage executive-level relationships with assigned health systems and provider organizations to support quality care, network development and stability, affordability, and resolution of barriers to success.
Serve as the primary point of accountability for complex and escalated provider issues, coordinating timely resolution with internal and external stakeholders.
Lead the development, negotiation, implementation, and ongoing management of complex provider contracts and reimbursement arrangements, including value-based and shared-risk arrangements, strategic network and contracting initiatives, cost-of-care strategies, quality and performance improvement programs, product strategy, provider incentive programs, and contract administration enhancements.
Lead cross-functional teams and stakeholder discussions to assign resources to provider issues and support strategic Plan initiatives.
Provide direct input on initiatives and serve as the subject-matter expert for assigned providers on contract and relationship status, trends, innovation, and emerging opportunities.
Partner with the strategic relationship support analyst to coordinate provider engagement, meet provider education needs, and proactively identify, resolve, and track organizational issues.
Jointly lead provider meetings and executive touchpoints, including agenda development, facilitation, action-item capture, documentation, and follow-up accountability.
Develop business cases, financial analyses, feasibility assessments, and forecasting models to evaluate contract opportunities, reimbursement strategies, and innovative provider arrangements.
Monitor provider performance and support initiatives that improve quality, affordability, member experience, and value-based care outcomes.