Sr. Manager, Provider Contracting

Blue Shield of California•Woodland Hills, CA

21h•Hybrid

About The Position

The Model Contracts team is responsible for the development and management of provider contract templates and related language that support the Blue Shield of California and Blue Shield of California Promise Health Plan networks across all lines of business. The Sr. Manager, Model Contracts will report to the Director, Network Operations. In this role you will be responsible for developing, maintaining, and optimizing standardized contract templates, exhibits, amendments, and related documentation used in provider and managed care contracting. This role partners closely with Legal, Network Management, Contracting, Finance, Compliance, Operations, and other stakeholders to ensure templates are clear, accurate, compliant, operationally usable, and aligned with business objectives. In addition, the Sr. Manager, Model Contracts will manage the Model Contracts team inclusive of Contract Specialists. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Requirements

Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
Requires at least 8 years of experience in health plan operations, provider contracting, network management, or related fields
Requires 4 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports
Requires extensive knowledge and expertise in managed healthcare in the California market including risk models, payment methodologies, regulatory compliance and end-to-end health plan operations
Requires excellent writing, editing, proofreading, and document organization skills, with the ability to convert complex requirements into clear and consistent contract language.
Requires excellent written and verbal communication skills with a proven track record in effective relationship building and influencing stakeholders at all levels of the organization
Strong attention to detail, analytical thinking, judgment, and ability to manage multiple priorities in a deadline-driven environment.
Ability to collaborate effectively with legal, business, operational, technical, and leadership stakeholders.
Proficiency with Microsoft Word, document management tools, version control practices, and contract lifecycle or workflow systems.

Nice To Haves

Advanced degree preferred (JD, MBA, MPH, MHA)

Responsibilities

Lead the designing, drafting, and updating of standardized contract templates, schedules, exhibits, amendments, notices, and other contracting documents for provider network agreements.
Manage the continuous review and modification of contracting strategies in anticipation of, and in response to, shifts in provider and competitor negotiating approaches as well as shifts in product design and/or market opportunities
Translate business, legal, regulatory, reimbursement, and operational requirements into practical template language that supports consistent contract execution and administration.
Partner with Legal and Compliance to ensure templates reflect applicable laws, regulations, delegation requirements, plan policies, accreditation standards, and internal governance expectations.
Develop intake models, clause playbooks, training materials, and process documentation to ensure Contracting teams apply appropriate templates consistently and timely.
Collaborate with Network Strategy and cross-functional teams related to new products, provider network strategies, reimbursement models, value-based arrangements, regulatory changes, and system implementations.
Support initiatives to improve and maintain highly competitive unit costs across all products to ensure that a superior provider network is available to all Blue Shield and Blue Shield Promise Health Plan members.
Lead the Model Contracts team by managing, hiring, training, and directing the Model Contracts Contracting Specialists to function as a high-performing team
Collaborate with Network Management, Provider Contracting, Finance, Operations, Claims, Credentialing, and Provider Data teams to ensure template provisions can be implemented accurately across downstream systems and processes.
Maintain a centralized template library, including version control, approved clauses, and drafting guidance.
Support contract standardization initiatives by identifying opportunities to simplify language, reduce variation, improve usability, and strengthen operational consistency.
Review stakeholder feedback, contract exceptions, recurring negotiation issues, and operational pain points to recommend template enhancements.