Innovative Provider Network Strategist

Job Overview

At Blue Cross and Blue Shield of North Carolina, we are seeking a highly skilled Innovative Provider Network Strategist to lead our most complex enterprise and divisional innovative provider reimbursement initiatives. As a key member of our team, you will be responsible for developing, articulating, negotiating, implementing, and managing these strategic initiatives with healthcare providers and integrated healthcare delivery systems.

As a seasoned professional in contracting and negotiation, you will drive comprehensive research, analysis, development, implementation, and negotiation of innovative provider network strategies. This includes value-based, shared risk arrangements, long-term strategic contracting initiatives, reducing cost of care, improving quality of care, product strategy and development, provider incentive programs, and contract administration improvements.

You will collaborate and coordinate with internal stakeholders to ensure the assignment of resources necessary to successfully implement strategic network initiatives. You will also lead select internal and external discussions regarding network strategies to ensure direct input into these initiatives and establish consistency within Blue Cross NC and among other Blues Plans.

Key responsibilities include researching, analyzing, and negotiating next-generation, innovative global provider network opportunities, recommending strategies, gaining plan approval for select provider strategies, implementing those strategies into provider contracts, and ensuring effective use of plan resources to administer approved strategies. You will also lead the development of feasibility models and forecasting the performance impact of innovative contracting strategies.

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