Posted: Wednesday, November 8, 2017 6:57 AM
About Blue Cross
Founded in 1933, Blue Cross and Blue Shield of Minnesota is the largest health plan in the state. We have more members, the largest network of providers and more products and services than any other plan in Minnesota. From the beginning, Blue Cross has been an innovator with a mission of making a healthy difference in people's lives.
We understand the importance of finding a job that you truly enjoy - at a company that shares your values. We've made it easy to feel good about working at Blue Cross by encouraging volunteerism, valuing diversity and offering the flexibility you need to live a balanced life. We offer a suite of comprehensive medical and dental benefits as well as competitive pay, flexible work schedules and generous personal paid time off in addition to 20 hours of volunteer paid time off each year. We look forward to serving Minnesotans over the next 80 years and beyond. Join us and make a healthy difference through the work you do every day.
Description Summary 13;
This highly visible position is responsible for negotiating provider contracts by developing provider relationships and negotiating renewal and new contracts with providers. This position coordinates work with provider contract administration, contracts and compliance, credentialing, provider finance and other departments or divisions of Blue Cross. 13;
:Develops and builds strong relationships with assigned provider accounts and manages all aspects of the provider relationship.
:Creates, implements and executes annual work plans to support existing or newly assigned strategic provider accounts to ensure timely performance of contractual duties.
:Prepares management and status reports that summarize the status and completion of ongoing contractual duties, arrnagement of the provider relationship, and contract negotiations for leadership.
:Participates on and may lead cross:functional teams that help further develop new models of strategic relationship options that can improve network performance for Blue Cross members.
:Identifies and defines business problems, strategies and tactics to provide solutions that provide value to Blue Cross, the provider and Blue Cross members. Responsible to execute on the solutions.
:Leads the negotiation of moderate to complex, sensitive and/or high dollar volume contracts. Manages negotiations against established budget targets and contract negotiations in a timely fashion to meet corporate deadlines.
:Analyzes complex data in conjunction with network finance or other corporate analysts. Interprets contracting and financial data for providers to use in provider negotiations.
:Extensive in:depth knowledge of complex payment methodologies, coding and reimbursement standards, contract language standards, contract compliance issues, claims processing operations, medical management practices, and quality standards and clinical initiatives that impact provider performance.
:Researches, analyzes and interprets key information on provider organizations, provider negotiation staff, and market contracting benchmarks to enhance negotiation effectiveness.
:Ensures that contracts and payment terms are negotiated in accordance with established contract administration policies and procedures, including regulatory requirements.
:Participates in divisional work groups as required by leadership.
:Mobilize and utilize corporate resources to achieve objectives of the division.
:Bachelors degree and 5 years of related work experience or 9 years of relevant or progressive healthcare experience in lieu of a degree.
:Displays strong ability to lead cross:functional teams.
:Excellent communications and interpersonal skills (internal/external).
:Ability to work across systems and functions to facilitate solutions and capabilities development.
:Demonstrated creativity in solution dev
• Location: Minneapolis / St. paul
• Post ID: 26652737 minneapolis