Principal Provider Contracting

Join Our Team as Principal, Provider Networks & Contracting!

Are you driven by a passion for enhancing healthcare delivery for behavioral health care services, and building impactful partnerships? BlueCross BlueShield of Tennessee’s Provider Networks & Contracting team is looking for a dynamic and detail-oriented Principal to join our mission of improving quality access to behavioral health care while ensuring affordability for our customers. In this role, you will utilize your expertise in contract negotiations, relationship management, and healthcare economics to establish and maintain cost-effective agreements with some of the largest and most prominent behavioral health care providers in the state. If you are a strategic thinker with exceptional analytical and problem-solving skills and a desire to innovate, we want to hear from you. Help us shape the future of behavioral healthcare and make a meaningful difference in the lives of our members.

You’ll be a great match for this role if, in addition to the above, you can demonstrate strong skills in public speaking and leadership qualities. This opportunity is ideal for someone with the ability to make informed decisions and effectively communicate those decisions with both internal and external partners.

Job Responsibilities

• Influences and executes multi-year network strategies, contract renewals and leadership support, influencing overall reimbursement strategies, mitigating unfavorable pricing impacts, addressing relationship challenges/opportunities and other using relevant market intelligence that informs and drives network strategies.
• Establishes processes and practices for contract negotiation and /or provider issue resolution; administering existing contracts and renewing strategic alliances.
• Interacts and works closely with all relevant areas within the organization to ensure provider contract strategies are supported and consistent with organizational business goals and regulations.
• Directs and/or participates in provider issue resolution and provider education across lines of business.
• Able to travel to provider offices or conduct virtual meetings as required.

Job Qualifications

Education

• Bachelor's Degree or equivalent work experience required.

Experience

• 5 years in Managed Care or equivalent with focus on health care contracting and/or network management experience. Specific to Behavioral Health direct experience with commercial and/or government insurance programs or direct experience with behavioral health provider/community-based programs.

Skills\Certifications

• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles, and accountability.
• Demonstrated knowledge and experience with a wide range of provider contracting arrangements, value-based reimbursement strategies and provider reimbursement methodologies.
• Proficient in Microsoft Office
• Direct experience in managing provider projects
• Excellent oral and written communication skills
• Strong interpersonal and organizational skills

Note: This role will require occasional face-to-face provider meetings and in-person staff meetings across the state of Tennessee.

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Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:

BCBST's EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

Tobacco-Free Hiring Statement

To further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco/nicotine test.  An individual whose post offer screening result is positive for illegal drugs or tobacco/nicotine  and/or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results.

Resources to help individuals discontinue the use of tobacco/nicotine products include smokefree.gov or 1-800-QUIT-NOW.