Director, Provider Contracting

Your Role

The Blue Shield of California (BSC) Network and Provider Partnership team is responsible for the BSC Provider Contracting and Provider Relations activities for BSC. The Director, Provider Contracting will report to the Vice President of Network and Provider Partnerships Southern California. In this role, you will be responsible for participating in and leading the network team's development of the multi-year contracting strategy for assigned providers and ongoing provider network maintenance. This will include unit cost trend targets and specific metrics to improve our overall competitive position. Additionally, you will lead cross functional work to drive process improvement opportunities for improved provider experience. You will also participate in committees and initiatives to help manage the total cost of health care for the lines of business for their assigned territory that typically results in savings of $1M+ plus in annual cost.

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.

Your Knowledge and Experience

• Requires a college degree or equivalent experience
• Requires 10 years of provider contracting experience at a senior negotiator level, including at least 6 years of people management experience at a health plan or in a provider organization
• Knowledge of health plan operations, products, and competitor marketplace
• Experience and working knowledge of the California provider marketplace
• Excellent interpersonal and communication skills, including effective delivery of executive level reports and in-person presentations
• Proficiency working with MS Office products (including Teams)]
• Ability and willingness to explore newer Artificial Intelligence (AI) tools

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.