Defence Global Product Cost Analyst
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Blue Cross NC is a health insurance company that provides health plans and related services for individuals and groups. Its work centers on helping members access healthcare coverage, supporting improved health outcomes through health programs and services, and contributing to the wellbeing of the communities it serves.
Senior Provider Contract Analyst at Blue Cross NC (Hybrid)
Develop and negotiate provider reimbursement strategies for Blue Cross NC. Oversee healthcare network contracts, quality initiatives, and provider relationships.
Description
- Evaluate, shape, negotiate, implement, and manage complex reimbursement initiatives across the enterprise and its divisions.
- Manage contracts with assigned healthcare provider systems.
- Research, analyze, develop, implement, and negotiate provider network strategies.
- Coordinate internal teams, staffing, and technology to deliver strategic network initiatives.
- Advise internal and external stakeholders on network strategies.
- Identify global provider network opportunities and recommend strategies.
- Secure plan approval and carry approved strategies through provider contract negotiations.
- Build feasibility models and forecast the performance impact of contracting strategies.
- Negotiate directly with key providers, including academic medical centers and multispecialty practices.
- Work with Network Management and internal partners to establish the operational and administrative capabilities needed for contract and service strategies.
Requirements
- Bachelor’s or advanced degree, where required.
- At least 5 years of experience in a related field.
- Seven or more years of related experience may substitute for a degree.
- Experience with complex project management; contracting strategy and administration; contract negotiations and healthcare contracts; healthcare networks and quality improvement; network development; people and project management; provider contracts and network management; resource allocation and management; and vendor relationships.
Benefits
- Work-life balance, flexibility, and autonomy.
- Medical, dental, and vision coverage.
- Health and wellness programs.
- Parental leave and support.
- Adoption and surrogacy assistance.
- Career development programs.
- Tuition reimbursement for continued education.
- 401(k) match with an annual company contribution.
- Paid time off.
- Annual incentive bonus based on corporate goal achievement and individual performance.
- Flexible remote work with planned in-person connection.
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