Value Based Contract Manager
Blue Cross Blue Shield of Arizona is a local, independent Blue Cross Blue Shield Association and a not-for-profit health insurance company headquartered in Phoenix. Founded in 1939, the company has more than 1,800 dedicated employees throughout its Phoenix, Tucson, Chandler and Flagstaff offices. Providing health insurance products, services and networks to more than 1 million Arizonans, Blue Cross Blue Shield of Arizona offers various health plans for individuals, families, and small and large businesses. Blue Cross Blue Shield of Arizona also offers Medicare supplement plans to individuals over age 65.
Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
Internal use only-Grade 31-32
Negotiates complex contracts with large, key healthcare providers (hospitals, physicians, etc.). Serves as the primary provider contracting contact and resource related to Provider Value Based contracts to improve BCBSAZ’s medical cost position, clinical outcomes, and overall competitiveness. Provides oversight, direction, development, problem resolution for all contracting activities related to Value Based Contracts. Ensures contracting department goals are achieved as assigned, including meeting contract financial targets and incorporating value based reimbursement as appropriate.
- Negotiate contracts with providers to achieve desired financial and relationship outcome.
- Work closely with Analytics and Actuarial to ensure all financial modeling is accurate based on assumptions provided. Understand and interpret financial analysis and use in negotiating contracts.
- Understand and utilize financial reimbursement methodologies that are value based and different from normal fee-for-service reimbursement methodologies, in order to align both provider and BCBSAZ interests.
- Support Value Based Reimbursement strategy area by developing contracts to support value-based arrangements made and ensuring they can be administered. Also involved in operationalizing and implementing contract after signed.
- Create linkages between Provider Contracting and Health Services to drive lower medical cost outcomes while maximizing provider and consumer engagement in improving health outcomes.
- Understand basics of contract language law and is able to negotiate contract language terms and conditions.
- Identify ways to increase the value and competitiveness of BCBSAZ network assets. Manage the day-to-day activities of a team of employees engaged in provider contracting functions.
- Maintain effective working relationships to ensure teamwork in achieving corporate goals.
- Coordinate activities between multiple divisions to achieve desired results.
- The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
- Perform all other duties as assigned.
- 3 years of experience in healthcare field related to Provider Contracting
- 1 year of experience in contracting Value Based Arrangements for Commercial and Medicare populations
- Bachelor’s Degree
- 5 years of progressive experience in the provider contracting field
- Master’s degree in business administration, healthcare administration, or related field and/or JD degree.
- Strong written and verbal communications.
- Intermediate financial acumen, including the ability to interpret financial analysis.
- Intermediate PC proficiency.
- Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones.
- Intermediate skill in word processing, spreadsheet and database software.
- Intermediate skill using departmental BCBSAZ and BCBSA software.
Required Professional Competencies
- Proven track record of negotiating difficult contracts to meet targeted goals.
- Strong ability to understand and interpret financial data and analyses.
- Ability to maintain confidentiality and privacy of data.
- Ability to plan, organize and manage the work of all assigned personnel.
- Proven leadership and management skills.
- Maintain confidentiality and privacy of data
- Analytical knowledge necessary to generate reports based on available data and then make decisions based on reported data
- Capable of investigative and analytical research
- Compose and dictate a variety of business correspondence
- Practice interpersonal and active listening to achieve high customer satisfaction and departmental communication standards
- Establish and maintain working relationships in a collaborative team environment
Required Leadership Experience and Competencies
- Make use of employees' skills and abilities to deliver business objectives
- Use available information to focus the team's activities, identify priorities and strengthen team effectiveness
BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.
Imagine doing life-changing work and helping more than one million Arizonans live healthier and longer lives. That’s the kind of satisfaction you’ll find when you work here. Our exceptional teams in Phoenix, Tucson, Chandler, and Flagstaff have been transforming healthcare for more than 80 years. Explore what's possible with a career at Blue Cross® BlueShield® of Arizona