Provider Contract Analyst

Job Description

Responsible for the assessment, development, articulation, negotiation, implementation and management of enterprise and divisional innovative provider reimbursement initiatives to be implemented with core network providers. Support team efforts to ensure Blue Cross NC holds a leading provider network capability position in the provider network dimension.

What You’ll Do

• Responsible for research, analysis, development, implementation and negotiation of innovative provider network strategies, including:
  • Value based, shared risk arrangements
  • Long-Term Strategic Contracting Initiatives
  • Reducing Cost of Care
  • Improving Quality of Care
  • Provider Incentive Programs
  • Contract Administration Improvements
• Communicate with internal stakeholders regarding the assignment of resources (FTEs, Technology, etc.) necessary to successfully implement the strategic network initiatives.
• Participate in select internal and external (BCBSA, vendors, etc.) discussions regarding network strategies to ensure Network Management has direct input into these initiatives, and establish consistency within Blue Cross NC and (where feasible) among other Blues Plans.
• Support the development of next generation, innovative global provider network opportunities through inputs to strategy recommendations and facilitating effective use of Plan resources to administer approved strategies.
• Provide analysis and inputs to feasibility models and forecasts of the performance impact of innovative contracting strategies.
• May participate in provider negotiations in a support role.
• Collaborate with internal stakeholders to ensure operational and administrative capabilities are established to implement contract and service strategies.

What You Bring

• Bachelor’s degree or advanced degree (where required)
• 3+ years of experience in related field.
• In lieu of degree, 5+ years of experience in related field.

Where You’ll Work

Our Hybrid Flex approach is built on presence with a purpose – giving flexibility to work remotely with intentional in‑person connection – that supports a workplace that’s flexible, connected, and future focused. In a Hybrid‑Flex role, you’ll work in the office at least two days a week for collaboration and connection. In a Remote‑Flex role, you’ll work virtually, with a few in‑office visits each year for meaningful moments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market‑price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$66,998.00 - $107,197.00

Skills

Skills section intentionally omitted due to no additional detail provided.