Provider Contract Analyst

Blue Cross and Blue Shield of North Carolina•Durham, NC

2d•Hybrid

About The Position

Responsible for the assessment, development, articulation, negotiation, implementation and management of enterprise and divisional innovative provider reimbursement initiatives to be implemented with core network providers. Support team efforts to ensure Blue Cross NC holds a leading provider network capability position in the provider network dimension.

Requirements

Bachelor's degree or advanced degree (where required)
3+ years of experience in related field.
In lieu of degree, 5+ years of experience in related field.

Responsibilities

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, Provider Incentive Programs, Contract Administration Improvements.
Communicate with internal stakeholders regarding the assignment of resources (FTEs, Technology, etc.) necessary to successfully implement the strategic network initiatives.
Participate in 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.
Support the development of next generation, innovative global provider network opportunities through inputs to strategy recommendations and facilitating effective use of Plan resources to administer approved strategies.
Provide analysis and inputs to feasibility models and forecasts of the performance impact of innovative contracting strategies.
May participate in provider negotiations in a support role.
Collaborate with internal stakeholders to ensure operational and administrative capabilities are established to implement contract and service strategies.